Hepatocellular carcinoma in patients listed for liver transplantation: Current and future allocation policy and management strategies for the individual patient

Joel P. Wedd, Eric Nordstrom, Trevor Nydam, Janette Durham, Michael Zimmerman, Thor Johnson, W. Thomas Purcell, Scott W. Biggins

Research output: Contribution to journalArticlepeer-review

Abstract

Liver transplantation can provide definitive cure for patients with cirrhosis and hepatocellular carcinoma (HCC) when used appropriately. Advances in the management of HCC have allowed improved control of HCC while waiting for liver transplantation and new approaches to candidate selection particularly with regard to tumor burden and downstaging protocols. Additionally, there have been recent changes in allocation policy related to HCC in the U.S. that cap the HCC MELD exception at 34 points and implement a 6-month delay in a HCC MELD exception. This review examines the U.S. liver transplant allocation policy related to HCC, comprehensively details locoregional therapy options in HCC patients awaiting liver transplantation, and considers the impact of an increasing burden of HCC on future liver graft allocation policy. Liver Transpl 21:1543-1552, 2015.

Original languageEnglish (US)
Pages (from-to)1543-1552
Number of pages10
JournalLiver Transplantation
Volume21
Issue number12
DOIs
StatePublished - Dec 1 2015

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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