Role of liver transplantation in the management of hepatocellular carcinoma

The treatment options for hepatocellular carcinoma (HCC) are liver resection, liver transplantation, or local ablation (e.g., percutaneous ethanol injection, cryosurgery, radio-frequency ablation, and chemoembolization). Most patients are not eligible for curative resection because of the location of the tumor or the severity of liver disease. For many of these patients, liver transplantation remains the best curative option. Because of the shortage of donor organs, much of the recent effort has been aimed at patient selection. In this review, the authors address outcomes after liver transplantation for HCC, the role of selection criteria as a predictor of mortality and recurrence, and the emerging role of living donor liver transplantation and chemoembolization.