Liver transplantation for intermediate hepatocellular carcinoma: An adaptive approach

Table 3 Eligibility criteria for downstaging of hepatocellular carcinoma before liver transplantation

Protocol	Inclusion criteria	Criteria for successful downstaging	Minimal observation period	Ref.
Bologna “rule of six”	Single HCC ≤ 6 cm	Milan criteria	3 mo	56
	2 HCC ≤ 5 cm
	Less than 6 HCCs ≤ 4 cm and a total tumor diameter ≤ 12 cm
	Absence of vascular or biliary invasion on CT/MRI
	AFP < 400 ng/mL during waiting time
San Francisco (UCSF)	Single HCC ≤ 8 cm	Milan criteria	3 mo	58
	2 or 3 HCC ≤ 5 cm (total tumor diameters ≤ 8 cm)
	4 or 5 HCC ≤ 3 cm (sum of maximal tumor diameters ≤ 8 cm)
	Absence of vascular invasion on CT/MRI

CT: Computed tomography; MRI: Magnetic resonance imaging; HCC: Hepatocellular carcinoma.