title: [Relevance of Ablation Therapies for HCC: "A Real Bridging" for Liver Transplantation?].
abstract: BACKGROUND
  The utilisation of interventional ablation procedures in the context of bridging and downstaging plans for hepatocellular carcinomas before liver transplantation is increasing. The aim of the present study was to summarise current data for the application of bridging and downstaging procedures before liver transplantation.
  
  
  METHODS
  The present study is based on an extensive investigation of the literature in PubMed. RESULTS of controlled trials, cohort studies, meta-analyses and reviews were included.
  
  
  RESULTS
  Recommendations for the usage of bridging procedures for hepatocellular carcinomas within the Milan criteria and an expected waiting time of more than 6 months until transplantation depend on the size of the lesions and have a low level of evidence. After successful downstaging of hepatocellular carcinomas beyond the Milan criteria into the range of the Milan criteria liver transplantation is recommended with a low level of evidence, as well.
  
  
  CONCLUSIONS
  Randomised controlled trials, clearly proving the success of bridging and downstaging procedures, are not available at the time and are not awaited for ethical reasons. Due to the uncomplicated application and low risk for therapy-associated complications, interventional procedures for bridging and downstaging are accepted and recommended.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: D P
authors.initials: DP
authors.lastname: Hoyer
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Lauenstein
authors.affiliation: Klinik für Nuklearmedizin, Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Bockisch
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: J-W
authors.initials: JW
authors.lastname: Treckmann
authors.affiliation: Klinik für Gastroenterologie und Hepatologie Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Deutschland.
authors.forename: Z
authors.initials: Z
authors.lastname: Mathé
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D019317:Evidence-Based Medicine; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D009367:Neoplasm Staging; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D014850:Waiting Lists