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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2008

Open Access 01-04-2008 | Hepatic and Pancreatic Tumors

Liver Transplantation for Hepatocellular Carcinoma

Authors: Vincenzo Mazzaferro, MD, Yun Shin Chun, MD, Ronnie T. P. Poon, MS, PhD, Myron E. Schwartz, MD, Francis Y. Yao, MD, J. Wallis Marsh, MD, Sherrie Bhoori, MD, Sung-Gyu Lee, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2008

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Abstract

Background

Orthotopic liver transplantation (OLT) is the best available option for early hepatocellular carcinoma (HCC), although its application is limited by stringent selection criteria, costs, and deceased donor graft shortage, particularly in Asia, where living donor liver transplant (LDLT) has been developed.

Methods

This article reviews the present standards for patient selection represented by size-and-number criteria with particular references to Milan Criteria and novel prediction models based on results achieved in patients exceeding those limits, with consideration of the expanded indication represented by the UCSF Criteria.

Results

The expected outcomes after deceased donor liver transplant (DDLT) or LDLT are favorable if predetermined selection criteria are applied. However, selection bias, difference in waiting time, and ischemia-regeneration injuries of the graft among DDLT vs LDLT may influence long-term results. In the article, the differences between East and West in first-line treatments for HCC (resection vs transplantation), indications, and ethics for the donor, are summarized as well as possible novel predictors of tumor biology (especially DNA mutation and fractional allelic loss, FAI) to be considered for better outcome prediction.

Conclusions

Liver transplantation remains the most promising product of modern surgery and represents a cornerstone in the management of patients with HCC.
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Metadata
Title
Liver Transplantation for Hepatocellular Carcinoma
Authors
Vincenzo Mazzaferro, MD
Yun Shin Chun, MD
Ronnie T. P. Poon, MS, PhD
Myron E. Schwartz, MD
Francis Y. Yao, MD
J. Wallis Marsh, MD
Sherrie Bhoori, MD
Sung-Gyu Lee, MD, PhD
Publication date
01-04-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9559-5

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