Journal
WORLD JOURNAL OF GASTROENTEROLOGY
Volume 24, Issue 32, Pages 3626-3636Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v24.i32.3626
Keywords
Hepatocellular carcinoma; Milan criteria; Liver transplantation; Living donor liver transplantation; Expanded criteria; Downstaging
Categories
Funding
- Association Llavaneres contra el Cancer [IP004500]
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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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