Liver Transplantation for Hepatocellular Carcinoma. Working Group Report from the ILTS Transplant Oncology Consensus Conference

Transplantation. 2020 Jun;104(6):1136-1142. doi: 10.1097/TP.0000000000003174.

Abstract

Liver transplantation (LT) offers excellent long-term outcome for certain patients with hepatocellular carcinoma (HCC), with a push to not simply rely on tumor size and number. Selection criteria should also consider tumor biology (including alpha-fetoprotein), probability of waitlist and post-LT survival (ie, transplant benefit), organ availability, and waitlist composition. These criteria may be expanded for live donor LT (LDLT) compared to deceased donor LT though this should not adversely affect the double equipoise in LDLT, namely ensuring both acceptable recipient outcomes and donor safety. HCC patients with compensated liver disease and minimal tumor burden have low urgency for LT, especially after local-regional therapy with complete response, and do not appear to derive the same benefit from LT as other waitlist candidates. These guidelines were developed to assist in selecting appropriate HCC patients for both deceased donor LT and LDLT.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery*
  • Consensus
  • Consensus Development Conferences as Topic
  • Donor Selection / standards*
  • Europe
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Liver Transplantation / methods
  • Liver Transplantation / standards*
  • Living Donors
  • Medical Oncology / methods
  • Medical Oncology / standards
  • Patient Safety
  • Patient Selection*
  • Practice Guidelines as Topic
  • Societies, Medical / standards
  • United States
  • Waiting Lists / mortality