Liver transplantation for hepatocellular carcinoma: Current update on treatment and allocation

Leigh Anne Dageforde, Kathryn J. Fowler, William C. Chapman

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Purpose of review This review discusses the current imaging modalities and criteria used to diagnose, and the role of liver transplantation as well as nonsurgical hepatic-directed therapies to treat hepatocellular carcinoma in the setting of chronic liver disease. Recent findings There has been continual evolution of guidelines, policies, and algorithms for the imaging diagnosis of hepatocellular carcinoma, particularly the Liver Imaging Reporting and Data System. The use of liverdirected therapy as a bridge to transplant is now common practice. Recently, patients have waited 6 months from listing before being granted a Model for End-Stage Liver Disease exception score of 28, with an increase every 3 months to a maximum score of 34. This policy change was developed to reduce disparities in outcomes for patients undergoing liver transplantation. Summary The use of liver transplantation to treat hepatocellular carcinoma within the Milan criteria has good outcomes with a 5-year disease-free survival rate comparable to patients transplanted without malignancy. The development of guidelines both for the radiologic diagnosis and staging of the primary tumor and guidelines for assessing response to treatment allows for a more unified approach to the management of patients. With the partnership of oncologists, hepatologists, radiologists, pathologists, and surgeons, the outcomes of liver transplantation as treatment for hepatocellular continue to improve.

Original languageEnglish
Pages (from-to)128-134
Number of pages7
JournalCurrent opinion in organ transplantation
Volume22
Issue number2
DOIs
StatePublished - Jan 1 2017

Keywords

  • Allocation
  • Hepatocellular carcinoma
  • Liver Imaging Reporting and Data System
  • Liver transplantation
  • Model for End-Stage Liver Disease
  • Yttrium-90

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