Hepatocellular Carcinoma and the Role of Liver Transplantation: A Review

Haris Muhammad, Aniqa Tehreem, Peng Sheng Ting, Merve Gurakar, Sean Young Li, Cem Simsek, Saleh A. Alqahtani, Amy K. Kim, Ruhail Kohli, Ahmet Gurakar

Research output: Contribution to journalArticlepeer-review


Hepatocellular carcinoma (HCC) is one of the leading causes of cancer deaths worldwide and liver transplantation (LT) is the only potentially curative treatment. Over the years, Milan criteria has been used for patient selection. There is ongoing research in this field with introduction of new biomarkers for HCC that can help guide future treatment. Furthermore, newer therapies for downstaging of the tumor are being implemented to prevent dropout from the transplant list. In addition, combination therapies for better outcome are under investigation. Interestingly, the concept of living-donor LT and possible use of hepatitis C virus-positive donors has been implemented as an attempt to expand the organ pool. However, there is a conflict of opinion between different centers regarding its efficacy and data is scarce. The aim of this review article is to outline the various selection criteria for LT, discuss the outcomes of LT in HCC patients, and explore future directions of LT for HCC. Therefore, a comprehensive PubMed/MEDLINE review was conducted. To expand our search, references of the retrieved articles were also screened for additional data. After selecting the studies, the authors independently reviewed them to identify the relevant studies. After careful evaluation 120 studies relevant to out topic are cited in the manuscript. Three tables and two figures are also included. In conclusion LT for HCC has evolved over the years. With the introduction of several expanded criteria beyond Milan, the introduction of bridging therapies, such as transcatheter arterial chemoembolization and radiofrequency ablation, and the approval of newer systemic therapies, it is evident that there will be more LT recipients in the future. It is promising to see ongoing trials and the continuous evolution of protocols. Prospective studies are needed to guide the development of a pre-LT criteria that can ensure low HCC recurrence risk and is not overly stringent, clarify the role of LDLT, and determine the optimal bridging therapies to LT.

Original languageEnglish (US)
Pages (from-to)738-748
Number of pages11
JournalJournal of Clinical and Translational Hepatology
Issue number5
StatePublished - 2021


  • Hepatocellular carcinoma
  • Liver transplantation
  • Locoregional therapies
  • Model for endstage liver disease
  • Trans-arterial radioembolization

ASJC Scopus subject areas

  • Hepatology


Dive into the research topics of 'Hepatocellular Carcinoma and the Role of Liver Transplantation: A Review'. Together they form a unique fingerprint.

Cite this