title: The estimated number of patients with hepatocellular carcinoma selected for liver transplantation using expanded selection criteria.
abstract: Recently, several groups have introduced expanded criteria for selection of patients with hepatocellular carcinoma (HCC) prior to transplant, but the exact number of potential newly recruited patients remains unclear. This registry-based study assessed 270 patients diagnosed with HCC. The potential number of transplant candidates was based on age (< or =65 years), absence of metastases and macro-vascular invasion, and on 12 previously published, expanded selection criteria. A wide range of increase in the number of transplant candidates was observed (12-63% when compared with the number of such candidates who would have been selected solely based on the Milan criteria). The most conservative criteria were Seoul (Kwon, 2007; increase of 12%), Valencia (Silva, 2008; 16%), total tumor volume/alpha-fetoprotein (Toso, 2009; 20%) and UCSF (Yao, 2007; 20%). This data will assist Centers and policy agencies in predicting the need for resources linked to an expansion of criteria.
authors.affiliation: Section of Hepatobiliary, Pancreatic and Transplant Surgery, University of Alberta, Edmonton, AB, Canada. christian.toso@hcuge.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Toso
authors.forename: Norman M
authors.initials: NM
authors.lastname: Kneteman
authors.forename: A M
authors.initials: AM
authors.lastname: James Shapiro
authors.forename: David L
authors.initials: DL
authors.lastname: Bigam
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018579:Patient Selection; D011300:Preoperative Care; D012042:Registries; D013997:Time Factors; D014850:Waiting Lists