Liver transplantation for hepatocellular carcinoma

In summary, a remarkable transformation has occurred in the management of patients with HCC over the last decade. It is now apparent that liver transplantation offers prolonged disease-free and overall survival for carefully selected patients with small HCCs and that there has been substantial growth in transplantation for this indication. Unfortunately, many patients present with advanced HCC that is not transplantable, or they may not be transplantation candidates because of other comorbidities. Transplantation is also not widely available in many countries where HCC is common. Screening for HCC in individuals at risk has been shown to identify HCC at an earlier stage, and this may make transplantation an even more important treatment option. Considerable controversy still remains about some aspects of transplantation for HCC - controversies that must be settled convincingly, given the scarcity of donor organs available for transplantation. Clearly, further research is needed to settle these controversies, and controlled clinical trials may be required in some instances. © 2005 by the American Gastroenterological Association.