Expansion of the hepatocellular carcinoma Milan criteria in liver transplantation: Future directions

World Journal of Gastroenterology : WJG
Mihai-Calin Pavel, Josep Fuster

Abstract

Milan criteria are currently the benchmark related to liver transplantation (LT) for hepatocellular carcinoma. However, several groups have proposed different expanded criteria with acceptable results. In this article, we review the current status of LT beyond the Milan criteria in three different scenarios-expanded criteria with cadaveric LT, downstaging to Milan criteria before LT, and expansion in the context of adult living donor LT. The review focuses on three main questions: what would the impact of the expansion beyond Milan criteria be on the patients on the waiting list; whether the dichotomous criteria (yes/no) currently used are appropriate for LT or continuous survival estimations, such as the one of "Metroticket" and whether it should enter into the clinical practice; and, whether the use of living donor LT in the context of expansion beyond Milan criteria is justified.

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Citations

Oct 15, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Hansen DangMindie H Nguyen
Jul 9, 2020·World Journal of Surgical Oncology·Mehmet Haluk MorgulMichael Bartels
Oct 23, 2019·Radiology·Eric vanSonnenberg, Peter R Mueller
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Oct 26, 2018·Canadian Journal of Gastroenterology & Hepatology·Xi-Zhen ChenYu-Sang Li
Jun 4, 2020·Annals of Gastroenterological Surgery·Michelle R Ju, Adam C Yopp
Jul 1, 2021·Clinical Transplantation·Maneerat ChayanupatkulThomas D Schiano
Mar 4, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Douglas N VanDerwerkenSommer E Gentry
Jul 24, 2021·Clinical and Molecular Hepatology·Incheon KangDong Jin Joo

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