title: Hepatocellular cancer and liver transplantation: a Western experience.
abstract: Orthotopic liver transplantation is the preferred treatment option in patients with hepatocellular carcinoma developing in chronic liver disease. Unfortunately, based on classical transplantation criteria (Milan criteria), only a minority of patients with hepatocellular carcinoma are candidate to orthotopic liver transplantation. Major improvements in treatment strategy and surgical technique including the use of neoadjuvant locoregional therapies and progresses of post-transplant immunosuppressive treatment have contributed to safely expand transplantation criteria preserving acceptable surgical morbidity-mortality and good oncologic outcome. Further extension of transplantation criteria may have  advantages including an increase in the number of transplant candidates and improvement of the prognosis of the disease and also disadvantages including an increase of surgical morbidity and deterioration of global oncologic outcome of orthotopic liver transplantation in hepatocellular carcinoma. In the future, identification of imaging or molecular prognostic markers could help to better define transplantation criteria.
authors.affiliation: Department of Imaging - Interventional Radiology, Université catholique de Louvain-UCL, Brussels, Belgium. jan.lerut@uclouvain.be
authors.forename: Jan
authors.initials: J
authors.lastname: Lerut
authors.forename: Olivier
authors.initials: O
authors.lastname: Julliard
authors.forename: Olga
authors.initials: O
authors.lastname: Ciccarelli
authors.forename: Valerie
authors.initials: V
authors.lastname: Lannoy
authors.forename: Pierre
authors.initials: P
authors.lastname: Gofette
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D006498:Hepatectomy; D006801:Humans; D007165:Immunosuppression Therapy; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016031:Liver Transplantation / Q000401:mortality; D018579:Patient Selection; D016896:Treatment Outcome