Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10413
Peer-review started: May 5, 2022
First decision: June 19, 2022
Revised: July 27, 2022
Accepted: August 25, 2022
Article in press: August 25, 2022
Published online: October 16, 2022
Liver transplantation (LT) for hepatocellular carcinoma is still a hot topic, and the main factor that is associated with the success of treatment is to determine the patients who will benefit from LT. Milan criteria have been defined 25 years ago and still is being used for patient selection for LT. However, in living donor LT, the Milan criteria is being extended. Current criteria for patient selection do not only consider morphologic characteristics such as tumor size and number of tumor nodules but also biologic markers that show tumor aggressiveness is also being considered. In the present review article, we have summarized all the criteria and scoring systems regarding LT for hepatocellular carcinoma. All criteria have 5-year overall survival rates that were comparable to the Milan Criteria and ranged between 60%-85%. On the other hand, it was seen that the recurrence rates had increased as the Milan criteria were exceeded; the 5-year recurrence rates ranged between 4.9% to 39.9%. Treatment of hepatocellular carcinoma needs a multidisciplinary approach. Ideal selection criteria are yet to be discovered. The same is true for treatment modalities. The goal will be achieved by a harmonic interplay between basic science researchers and clinicians.
Core Tip: Hepatocellular carcinoma is the third most common cause of cancer-related deaths. Liver transplantation has an important place in the treatment of hepatocellular carcinoma. However, there is no consensus on which patients should receive a liver transplantation. For this reason, various criteria have been defined. In this study, we will discuss the criteria defined by our liver transplant institute in light of a literature analysis.