Downstaging and Expanded Criteria Hepatocellular Carcinoma Liver Transplantation

被引：0
作者：
Abreu P. [1 ]
Gorgen A. [1 ]
Griffiths C. [2 ]
Ivanics T. [1 ]
Sapisochin G. [1 ]
机构：
[1] Department of Surgery, Multi-Organ Transplant Program, University Health Network/University of Toronto, 585 University Ave., Toronto, M5G 2N2, ON
[2] Department of Surgery, Division of General Surgery, McMaster University, Toronto, ON
来源：
Current Hepatology Reports | 2019年 / 18卷 / 4期
关键词：
Downstaging; Hepatocellular carcinoma; Liver transplantation; Locoregional therapies; Transplant criteria;
D O I：
10.1007/s11901-019-00492-y
中图分类号：
学科分类号：
摘要：
Purpose of Review: Liver transplantation (LT) has been utilized in the last two decades for the treatment of selected patients with hepatocellular carcinoma (HCC). Currently, in most jurisdictions worldwide, only tumor size and number determine transplant candidacy, which may not sufficiently predict tumor behavior. Both tumor downstaging and expanding transplant criteria play an important role in expanding access to LT for HCC patients. Recent Findings: New downstaging protocols are emerging that incorporate response to locoregional therapies (LRT) among those that initially present beyond the accepted Milan criteria. In parallel, new serologic, histologic, and radiographic tools are being identified that may better predict outcomes after LT for HCC, in so-called extended criteria. The efforts of different jurisdictions worldwide in creating new treatment protocols have made it possible to evaluate and compare outcomes of patients over time. Summary: Improvements of LRT and expansion of the criteria for LT for HCC will both play a role in optimizing outcomes for patients with HCC. © Springer Science+Business Media, LLC, part of Springer Nature 2019.
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页码：400 / 407
页数：7
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