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Liver Transplantation for the Treatment of Hepatocellular Carcinoma

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Liver Cancers

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Abstract

Liver transplantation is established as an effective treatment for chronic liver diseases. HCC is a common complication of liver cirrhosis. Early stage HCC can be treated by liver transplantation with excellent outcomes, whereas advanced HCC has a poor prognosis. Criteria based on size and number of HCC are commonly used to identify patients likely to benefit from liver transplantation; however, even in highly selected patients HCC recurrence may still occur.

Strategies to refine patient selection to minimise the risk of recurrence include pre-transplant serological markers such as AFP or DCP and response to locoregional treatment. Downstaging of more advanced HCC using locoregional treatment may allow these patients to access transplantation with a good outcome. Novel biomarkers such as circulating tumour DNA, circulating cancer cell or non-coding RNA are areas of active research. Advances in organ retrieval using machine perfusion may also expand the donor pool and improve post-transplant graft function in patients receiving marginal donor organs, which are more frequently offered to patients with HCC. The role of novel systemic therapies in treatment of post-transplant recurrence is yet to be established.

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Authors and Affiliations

  1. The Sheila Sherlock Centre for Hepatology and Liver Transplantation, The Royal Free Hospital, London, UK

    Aileen Marshall

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  1. Aileen Marshall
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Correspondence to Aileen Marshall .

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Editors and Affiliations

  1. Royal Liverpool University Hospital, Liverpool, Merseyside, UK

    Tim Cross

  2. University of Liverpool, Liverpool Early Drug Development Unit, Liverpool, UK

    Daniel H. Palmer

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Marshall, A. (2019). Liver Transplantation for the Treatment of Hepatocellular Carcinoma. In: Cross, T., Palmer, D. (eds) Liver Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-92216-4_8

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  • DOI: https://doi.org/10.1007/978-3-319-92216-4_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92215-7

  • Online ISBN: 978-3-319-92216-4

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