Semin Liver Dis 2021; 41(02): 172-181
DOI: 10.1055/s-0041-1723032
Review Article

Liver Transplantation Selection and Allocation Criteria for Hepatocellular Carcinoma: A European Perspective

Beat Moeckli
1  Department of Visceral and Transplantation Surgery, University of Geneva Hospitals, Geneva, Switzerland
,
Pietro Majno
2  Epatocentro, Ospedale Regionale di Lugano, Lugano, Switzerland
,
Lorenzo A. Orci
1  Department of Visceral and Transplantation Surgery, University of Geneva Hospitals, Geneva, Switzerland
,
Andrea Peloso
1  Department of Visceral and Transplantation Surgery, University of Geneva Hospitals, Geneva, Switzerland
,
Christian Toso
1  Department of Visceral and Transplantation Surgery, University of Geneva Hospitals, Geneva, Switzerland
› Author Affiliations
Funding Statement The authors received no specific funding for this work.

Abstract

For patients with early-stage hepatocellular carcinoma (HCC), liver transplantation offers the best chance of cure. Over the past two decades, selection criteria to determine eligibility for liver transplantation have been constantly refined but a fair allocation strategy of liver grafts to HCC patients remains challenging. In Europe, over a dozen transplantation networks apply different liver transplantation criteria for HCC patients. In this review, we explore and compare candidate selection and liver graft allocation strategies for patients with HCC with a European perspective and discuss the ethical and technical challenges involved. In addition, we suggest possible paths for future improvement such as transitioning from fixed selection and allocation criteria to a more flexible model of benefit, which includes criteria concerning the graft, response to treatment, the biology of the tumor, and other relevant recipient factors.



Publication History

Publication Date:
06 May 2021 (online)

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