Copyright
©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2018; 24(32): 3626-3636
Published online Aug 28, 2018. doi: 10.3748/wjg.v24.i32.3626
Published online Aug 28, 2018. doi: 10.3748/wjg.v24.i32.3626
Expansion of the hepatocellular carcinoma Milan criteria in liver transplantation: Future directions
Mihai-Calin Pavel, Josep Fuster, HepatoBilioPancreatic Surgery and Transplant Unit, Department of Surgery, Digestive and Metabolic Diseases Institute, Hospital Clínic, University of Barcelona, Barcelona, Catalonia 08036, Spain
Josep Fuster, Barcelona-Clínic Liver Cancer Group (BCLC), Liver Unit, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBEREHD, Universitat de Barcelona, Barcelona, Catalonia 08036, Spain
Author contributions: Both authors contributed equally to this manuscript’s conception, design, analysis and writing.
Supported by the Association Llavaneres contra el Cáncer , No. IP004500 (to Fuster J).
Conflict-of-interest statement: Both authors declare no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Josep Fuster, MD, PhD, Professor of Surgery, HepatoBilioPancreatic Surgery and Transplant Unit, Digestive and Metabolic Diseases Institute, Hospital Clínic, University of Barcelona, C: Villaroel 170, escalera 10 planta 3, Barcelona 08036, Spain. jfuster@clinic.cat
Telephone: +34-93-2275718 Fax:+34-93-2275589
Received: April 21, 2018
Peer-review started: April 21, 2018
First decision: May 9, 2018
Revised: June 24, 2018
Accepted: June 30, 2018
Article in press: June 30, 2018
Published online: August 28, 2018
Processing time: 128 Days and 3.6 Hours
Peer-review started: April 21, 2018
First decision: May 9, 2018
Revised: June 24, 2018
Accepted: June 30, 2018
Article in press: June 30, 2018
Published online: August 28, 2018
Processing time: 128 Days and 3.6 Hours
Core Tip
Core tip: After more than 20 years since their first description, the Milan criteria still represent the benchmark in liver transplantation for hepatocellular carcinoma. This review focuses on three unresolved issues, those being: the impact of expansion beyond Milan criteria for patients on the liver transplant waiting list; whether the dichotomous criteria (yes/no) currently used are appropriate for liver transplantation or continuous survival estimations, such as the one of “Metroticket” and whether it should enter into the clinical practice; and, whether the use of living donor liver transplantation in the context of expansion beyond Milan criteria is justified.