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Liver Transplantation for Hepatocellular Carcinoma

Current Gastroenterology Reports volume 17, Article number: 11 (2015) Cite this article

Abstract

Hepatocellular carcinoma (HCC) is an increasing problem in the USA and worldwide. Current treatments for HCC include chemoembolization, radioembolization, liver resection, and liver transplantation in the setting of selected cirrhotic patients. Liver transplantation for HCC was controversial initially, but is now widely accepted as a curative approach. Cirrhotic patients who meet standards for transplantation and have a tumor burden within Milan criteria are eligible for transplantation and receive Model for End-Stage Liver Disease (MELD) exception points once listed. Given the decline in availability of donor organs, rewarding MELD exception points and performing liver transplants in these patients remain controversial. Despite this, various guidelines propose expanding eligibility criteria for cirrhotics with HCC, due to post-transplant outcomes comparable to patients transplanted without HCC. Following the transplant, issues include optimizing the type and amount of immunosuppression and screening for and treating recurrence of HCC.

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Conflict of Interest

M. Katherine Rude declares that she has no conflict of interest.

Jeffrey S. Crippin has received a consultancy fee from Abbvie; has provided expert testimony for Bayer; honoraria from Janssen and Abbvie; payment for development of educational presentations from AbbVie, Gilead, Genentech, Merck, Salix, and Vertex; and travel expense reimbursement from AbbVie, Gilead, Genentech, Janssen, Merck, Salix, and Vertex.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8124, St. Louis, MO, 63110, USA

    M. Katherine Rude & Jeffrey S. Crippin

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  1. M. Katherine Rude
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  2. Jeffrey S. Crippin
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Correspondence to Jeffrey S. Crippin.

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This article is part of the Topical Collection on Liver

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Cite this article

Rude, M.K., Crippin, J.S. Liver Transplantation for Hepatocellular Carcinoma. Curr Gastroenterol Rep 17, 11 (2015). https://doi.org/10.1007/s11894-015-0435-3

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  • DOI: https://doi.org/10.1007/s11894-015-0435-3

Keywords

  • Hepatocellular carcinoma
  • Liver transplant
  • UNOS
  • MELD
  • Milan criteria
  • UCSF criteria