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Liver Transplantation for HCC: The Milan Criteria

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Contemporary Liver Transplantation

Abstract

Liver transplantation represents a potentially curative intervention for patients with hepatocellular carcinoma and in fact is an important indication for transplant evaluation. However, early experiences with liver transplantation for this indication were characterized by dismal outcomes, mediated by high rates of posttransplant cancer recurrence. Based on these early experiences, the role of liver transplant for HCC patients was in serious doubt. This chapter reviews the importance of, and the substantial challenges confronting, the Milan Criteria. These criteria are currently used by the global transplant community to determine transplant candidacy of HCC patients. It was the development of these criteria which allowed identification of a subset of HCC patients who are predicted to have good outcomes after liver transplantation. This in turn ensured the continued role of liver transplantation as a lifesaving therapeutic intervention for this group of patients. This chapter reviews the data leading to the development of the Milan Criteria and their validation and discusses some current challenges to the application of these criteria to patients under consideration for liver transplant today.

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Abbreviations

AASLD:

American Association for the Study of Liver Disease

APASL:

Asian Pacific Association for the Study of the Liver

BCLC:

Barcelona Clinic Liver Cancer

EASL:

European Association for the Study of the Liver

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

LI-RADS:

Liver Imaging Reporting and Data System

NIH:

National Institutes of Health

OPTN:

Organ Procurement and Transplantation Network

UNOS:

United Network for Organ Sharing

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Authors and Affiliations

  1. Department of Medicine, Division of GI/Hepatology, Thomas Jefferson University, 132 South 10th Street, Suite 480 Main Building, Philadelphia, PA, 19107, USA

    Jesse M. Civan

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  1. Jesse M. Civan
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Correspondence to Jesse M. Civan .

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Editors and Affiliations

  1. Jefferson Liver Tumor Center Division of Transplantation, Thomas Jefferson University Hospital Kimmel Cancer Center, Philadelphia, Pennsylvania, USA

    Cataldo Doria

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Civan, J.M. (2016). Liver Transplantation for HCC: The Milan Criteria. In: Doria, C. (eds) Contemporary Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-05543-5_11-2

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  • DOI: https://doi.org/10.1007/978-3-319-05543-5_11-2

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Chapter history

  1. Latest

    Liver Transplantation for HCC: The Milan Criteria
    Published:
    11 October 2016

    DOI: https://doi.org/10.1007/978-3-319-05543-5_11-2

  2. Original

    Liver Transplantation for HCC: The Milan Criteria
    Published:
    11 June 2016

    DOI: https://doi.org/10.1007/978-3-319-05543-5_11-1

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