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Advances in How We Prioritize Liver Allocation for Hepatocellular Carcinoma in the USA

  • Liver Transplantation (D Mulligan, Section Editor)
  • Published:
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Abstract

Treatment options for hepatocellular carcinoma (HCC) have changed significantly, beginning in 1994 with the establishment of successful long-term outcomes for HCC patients within Milan criteria who went on to receive liver transplantation (LT). Improved outcomes for patients with HCC undergoing LT led to challenges in determining the optimal liver allocation policy, which could provide relatively equal access for patients with and without HCC in the face of a long-standing critical shortage of available donor organs. United Network for Organ Sharing/Organ Procurement Transplantation Network (UNOS/OPTN) policy changes have aimed to optimize data collection for patients transplanted with HCC, improve the diagnostic criteria required for HCC, and reduce the disparity in access to transplantation for HCC and non-HCC patients observed between high- and low-model for end-stage liver disease (MELD) regions. Although current understanding of HCC tumor biology remains suboptimal, continued careful analysis of waitlist and post-transplant outcomes for both HCC and non-HCC patients combined with refinements to the allocation policy will hopefully result in improved survival both for waitlisted and post-transplant patients.

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Authors and Affiliations

  1. Division of Transplant Surgery, William J. von Liebig Transplant Center, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA

    Caroline C. Jadlowiec & Julie K. Heimbach

Authors
  1. Caroline C. Jadlowiec
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  2. Julie K. Heimbach
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Correspondence to Julie K. Heimbach.

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Julie Heimbach and Caroline Jadlowiec declare no conflict of interest.

Human and Animal Rights and Informed Consent

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

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This article is part of the Topical Collection on Liver Transplantation

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Jadlowiec, C.C., Heimbach, J.K. Advances in How We Prioritize Liver Allocation for Hepatocellular Carcinoma in the USA. Curr Transpl Rep 3, 334–340 (2016). https://doi.org/10.1007/s40472-016-0127-4

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  • DOI: https://doi.org/10.1007/s40472-016-0127-4

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