Selection of candidates with HCC for transplantation in the MELD era.
1. Liver transplantation is the main option for patients with early HCC who are not optimal candidates for surgical resection. 2. Shortage of donors is its main limitation, as waiting for a liver allows the tumor to progress and induce exclusion from the waiting list and death. 3. The absence of randomized controlled trials hinders the establishment of the most effective therapy to prevent tumor progression while waiting. 4. Live donation may be a cost-effective approach if optimal results are expected and the mortality risk for the donor is kept below .3%. 5. Priority policies have to be developed and refined to provide a fair and effective distribution of cadaveric organs.
Sala
Margarita
M
Barcelona-Clinic-Liver-Cancer Group, Liver Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Varela
Maria
M
Bruix
Jordi
J
D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003661:Decision Support Techniques; D006801:Humans; D017093:Liver Failure / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D015233:Models, Statistical; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D011379:Prognosis; D012720:Severity of Illness Index; D009927:Tissue and Organ Procurement; D014850:Waiting Lists