Published online Jun 27, 2019. doi: 10.4240/wjgs.v11.i6.287
Peer-review started: May 10, 2019
First decision: May 31, 2019
Revised: June 13, 2019
Accepted: June 20, 2019
Article in press: June 21, 2019
Published online: June 27, 2019
Processing time: 49 Days and 14.6 Hours
Hepatocellular carcinoma is one of the leading malignancies worldwide. Early detection of hepatocellular carcinoma and its management in the form of liver transplantation offers an attractive treatment option. The Milan criteria, proposed by Mazzaferro et al, have been the standard for selecting patients with hepatocellular carcinoma for transplantation. Recently, several studies have shown that even patients selected outside the Milan criteria can undergo transplantation with a relatively good outcome. This article examines the currently existing criteria other than the Milan criteria and also evaluates use of alpha-fetoprotein and positron emission tomography scans to predict the chance of recurrence.
Core tip: The Milan criteria have been used extensively worldwide to select patients with hepatocellular carcinoma for liver transplantation. Over the years, it has been questioned whether the Milan criteria are too restrictive and whether patients outside the Milan criteria could benefit from liver transplantation. Several other criteria have been proposed and validated, and latest is the hepatocellular carcinoma Metroticket concept. This minireview evaluates the various current criteria that exist for liver transplantation for hepatocellular carcinoma cases.