Liver transplantation for hepatocellular carcinoma - factors influencing outcome and disease-free survival

Table 2 Overview of prioritization systems in different transplant regions worldwide

Region	Country	Basic listing	Standard exception	Patient benefit
Eurotransplant	Germany		1 tumor > 2 and < 5 cm up to 3 tumors > 1 and < 3 cm	Initial listing with MELD 22; upgrading every 3 mo by 10% mortality risk
	The Netherlands		1 tumor > 2 and < 5 cm up to 3 tumors > 1 and < 3 cm	Initial listing with MELD 20; upgrading every 3 mo by 10% mortality risk
				However, “test of time”: patient must have been on the waiting list for 6 mo prior
	Austria	Possible (if Milan criteria are met); however, irrelevant with center-based allocation	No
Europe	United Kingdom	Single lesion < 5 cm		No prioritization on the waiting list
		Up to 5 lesions < 3 cm
		Single lesion between 5 and 7 cm without progression over 6 mo
		No extrahepatic tumor
		No macrovascular invasion AFP < 1000 U/L
	France	Complex French Liver Allocation Score under consideration of
		Lab-MELD-Scores
		Tumor stage (T2 ranked higher than T1)
		Elapsed waiting time
		Distance between donor and Recipient hospital
	Switzerland		1 tumor > 2 and < 5 cm	Lab-MELD + 1.5 points per month
			up to 3 tumors > 1 and < 3 cm
North America	United States		1 tumor > 2 and < 5 cm	Initial listing with MELD 22; upgrading every 3 mo by 10% mortality risk
			up to 3 tumors > 1 and < 3 cm
South America	Brazil		1 tumor < 5 cm	Initial listing with 20 points, increase to 24 points after 3 mo and 29 points after 6 mo
			up to 3 tumors of less than 3 cm each