Copyright ©The Author(s) 2019.
World J Gastroenterol. Jun 7, 2019; 25(21): 2591-2602
Published online Jun 7, 2019. doi: 10.3748/wjg.v25.i21.2591
Table 1 Characteristics and results of the different allocation systems adopted for liver transplantation in hepatocellular carcinoma
Selection systemYear of proposalCriteriaSurvival/years of follow-up
Milan criteria1996Single lesion ≤ 5 cm; up to three separate lesions, none larger than 3 cm; no evidence of gross vascular invasion; and no regional nodal or distant metastases85%/4[8]
University of California, San Francisco criteria2007Single nodule up to 6.5 cm or up to three lesions, the largest of which is 4.5 cm or smaller and the sum of the diameters no larger than 8 cm80.9%/5[9]
Up-to-seven criteria2009Sum of size (in cm) of larger tumor plus number of tumors ≤ 771.2%/5[12]
Total tumor volume and alpha-fetoprotein criteria2009Total tumor volume ≤ 115 cm3 and alpha-fetoprotein ≤ 400 ng/mL, without macrovascular invasion or extrahepatic disease74.6%/4[11]
Kyoto criteria2013≤ 10 tumors; ≤ 5 cm; and des-gamma-carboxy prothrobine ≤ 400 mAU/mL65%/5[13]
Extended Toronto criteria2016Any size or number of tumors, without systemic cancer-related symptoms, extrahepatic disease, vascular invasion, or a poorly differentiated largest lesion at percutaneous tumor biopsy.68%/5[10]
Table 2 Techniques employed for bridging or downstaging patients with hepatocellular carcinoma before liver transplantation and their efficacy
TACE0-35% (39)24%-77% (57)
RadioembolizationNA (49)11%-43% (57)
RFA16.8% (50)NA
SBRT16.7% (50)NA
ResectionNA (40, 42)NA
Combined approach (TACE + RFA or radioembolization)NA56% (58)