{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T13:11:27Z","timestamp":1779109887394,"version":"3.51.4"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Supplement 2","license":[{"start":{"date-parts":[[2011,10,1]],"date-time":"2011-10-01T00:00:00Z","timestamp":1317427200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2011,9,26]],"date-time":"2011-09-26T00:00:00Z","timestamp":1316995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Key Points<\/jats:p>\n            <jats:p>1. Liver transplantation is currently an effective therapy for patients with HCC who meet the Milan criteria.<\/jats:p>\n            <jats:p>2. The proportion of patients on waiting lists for liver transplantation who have HCC has increased substantially in recent years. HCC is currently one of the major indications for liver transplantation; it is the indication for approximately one-third of liver transplants.<\/jats:p>\n            <jats:p>3. If the Milan criteria are not met, the survival rates after liver transplantation for HCC tend to decrease, mainly because of the catastrophic consequences of HCC recurrence.<\/jats:p>\n            <jats:p>4. A few studies have supported liver transplantation when the Milan criteria are exceeded, but extensions beyond the Milan criteria remain controversial. Even if an individual patient with HCC who does not meet the Milan criteria might benefit from liver transplantation, the limited number of currently available donor organs limits the indications for liver transplantation to those patients with HCC who have the greatest likelihood of survival after the procedure.<\/jats:p>\n            <jats:p>5. To patients with early-stage HCC, surgical resection can be offered if the hepatocellular function is well maintained and severe portal hypertension is not present.<\/jats:p>\n            <jats:p>6. To enable patients with HCC to have access to liver transplantation that is similar to the access for other patients without HCC in the MELD allocation system, additional points based on the number and size of HCC lesions are assigned to patients on the waiting list. However, this system requires further refinement to ensure that it is as fair as possible.<\/jats:p>\n            <jats:p>7. Liver transplantation for HCC should be restricted to those patients who are expected to have the same posttransplant survival as that of patients with nonneoplastic end-stage chronic liver disease.<\/jats:p>\n            <jats:p>8. On the basis of these considerations, a 5-year survival rate of 50% after liver transplantation for HCC seems too low. Liver Transpl, 2011. \u00a9 2011 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.22423","type":"journal-article","created":{"date-parts":[[2011,8,20]],"date-time":"2011-08-20T09:34:41Z","timestamp":1313832881000},"page":"S6-S13","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":50,"title":["Toward optimizing the indications for orthotopic liver transplantation in hepatocellular carcinoma"],"prefix":"10.1097","volume":"17","author":[{"given":"Didier","family":"Samuel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Colombo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hachem","family":"El-Serag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolphe","family":"Sobesky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel","family":"Heaton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"pt 2","key":"R1-2-20250124","first-page":"10031019","article-title":"Liver transplantation in the United States, 19992008.","volume":"10","author":"Thuluvath","year":"2010","journal-title":"Am J Transplant"},{"key":"R2-2-20250124","first-page":"17521763","article-title":"Diagnosis and treatment of hepatocellular carcinoma.","volume":"134","author":"ElSerag","year":"2008","journal-title":"Gastroenterology"},{"key":"R3-2-20250124","first-page":"745750","article-title":"Rising incidence of hepatocellular carcinoma in the United States.","volume":"340","author":"ElSerag","year":"1999","journal-title":"N Engl J Med"},{"key":"R4-2-20250124","doi-asserted-by":"crossref","first-page":"214215","DOI":"10.1016\/S0140-6736(05)78179-4","article-title":"Trends in primary liver cancer.","volume":"351","author":"Deuffic","year":"1998","journal-title":"Lancet"},{"issue":"suppl 1","key":"R5-2-20250124","first-page":"S5S16","article-title":"Primary liver cancer: worldwide incidence and trends.","volume":"127","author":"Bosch","year":"2004","journal-title":"Gastroenterology"},{"key":"R6-2-20250124","doi-asserted-by":"crossref","first-page":"74108","DOI":"10.3322\/canjclin.55.2.74","article-title":"Global cancer statistics, 2002.","volume":"55","author":"Parkin","year":"2005","journal-title":"CA Cancer J Clin"},{"key":"R7-2-20250124","first-page":"25572576","article-title":"Hepatocellular carcinoma: epidemiology and molecular carcinogenesis.","volume":"132","author":"ElSerag","year":"2007","journal-title":"Gastroenterology"},{"key":"R8-2-20250124","doi-asserted-by":"crossref","first-page":"6267","DOI":"10.1002\/hep.510290145","article-title":"Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials.","volume":"29","author":"Llovet","year":"1999","journal-title":"Hepatology"},{"key":"R9-2-20250124","doi-asserted-by":"crossref","first-page":"417422","DOI":"10.1007\/s00432-004-0552-0","article-title":"Randomized controlled trial of screening for hepatocellular carcinoma.","volume":"130","author":"Zhang","year":"2004","journal-title":"J Cancer Res Clin Oncol"},{"key":"R10-2-20250124","doi-asserted-by":"crossref","first-page":"291297","DOI":"10.1016\/j.jhep.2010.03.010","article-title":"; for Italian Liver Cancer (ITA.LI.CA) Group. Semiannual surveillance is superior to annual surveillance for the detection of early hepatocellular carcinoma and patient survival.","volume":"53","author":"Santi","year":"2010","journal-title":"J Hepatol"},{"key":"R11-2-20250124","doi-asserted-by":"crossref","first-page":"733738","DOI":"10.1016\/0016-5085(90)90296-D","article-title":"Resection of hepatocellular carcinomas. Results in 72 European patients with cirrhosis.","volume":"98","author":"Franco","year":"1990","journal-title":"Gastroenterology"},{"key":"R12-2-20250124","doi-asserted-by":"crossref","first-page":"14341440","DOI":"10.1002\/hep.510300629","article-title":"Intentiontotreat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation.","volume":"30","author":"Llovet","year":"1999","journal-title":"Hepatology"},{"key":"R13-2-20250124","doi-asserted-by":"crossref","first-page":"16181624","DOI":"10.1016\/0016-5085(94)90419-7","article-title":"Predictive factors for postoperative recurrence of hepatocellular carcinoma.","volume":"106","author":"Okada","year":"1994","journal-title":"Gastroenterology"},{"key":"R14-2-20250124","doi-asserted-by":"crossref","first-page":"703710","DOI":"10.1097\/01.sla.0000094549.11754.e6","article-title":"Selection criteria for repeat hepatectomy in patients with recurrent hepatocellular carcinoma.","volume":"238","author":"Minagawa","year":"2003","journal-title":"Ann Surg"},{"key":"R15-2-20250124","doi-asserted-by":"crossref","first-page":"216222","DOI":"10.1097\/00000658-199902000-00009","article-title":"Intrahepatic recurrence after curative resection of hepatocellular carcinoma: longterm results of treatment and prognostic factors.","volume":"229","author":"Poon","year":"1999","journal-title":"Ann Surg"},{"key":"R16-2-20250124","doi-asserted-by":"crossref","first-page":"768775","DOI":"10.1016\/0016-5085(95)90450-6","article-title":"Risk factors for intrahepatic recurrence in human small hepatocellular carcinoma.","volume":"108","author":"Adachi","year":"1995","journal-title":"Gastroenterology"},{"key":"R17-2-20250124","doi-asserted-by":"crossref","first-page":"270285","DOI":"10.1007\/BF01659064","article-title":"Surgical treatment of hepatocellular carcinoma: experience with liver resection and transplantation in 198 patients.","volume":"15","author":"Ringe","year":"1991","journal-title":"World J Surg"},{"key":"R18-2-20250124","first-page":"22962298","article-title":"Orthotopic liver transplantation: treatment of choice in cirrhotic patients with hepatocellular carcinoma?","volume":"27","author":"Moreno","year":"1995","journal-title":"Transplant Proc"},{"key":"R19-2-20250124","doi-asserted-by":"crossref","first-page":"221228","DOI":"10.1097\/00000658-199109000-00005","article-title":"Hepatic resection versus transplantation for hepatocellular carcinoma.","volume":"214","author":"Iwatsuki","year":"1991","journal-title":"Ann Surg"},{"key":"R20-2-20250124","doi-asserted-by":"crossref","first-page":"401407","DOI":"10.1097\/00000658-198510000-00001","article-title":"Role of liver transplantation in cancer therapy.","volume":"202","author":"Iwatsuki","year":"1985","journal-title":"Ann Surg"},{"key":"R21-2-20250124","doi-asserted-by":"crossref","first-page":"145151","DOI":"10.1097\/00000658-199308000-00005","article-title":"Liver resection versus transplantation for hepatocellular carcinoma in cirrhotic patients.","volume":"218","author":"Bismuth","year":"1993","journal-title":"Ann Surg"},{"issue":"pt 2","key":"R22-2-20250124","first-page":"10661067","article-title":"Surgical treatment of hepatocellular carcinoma in cirrhosis: liver resection or transplantation?","volume":"25","author":"Bismuth","year":"1993","journal-title":"Transplant Proc"},{"key":"R23-2-20250124","doi-asserted-by":"crossref","first-page":"693699","DOI":"10.1056\/NEJM199603143341104","article-title":"Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis.","volume":"334","author":"Mazzaferro","year":"1996","journal-title":"N Engl J Med"},{"key":"R24-2-20250124","doi-asserted-by":"crossref","first-page":"13941403","DOI":"10.1053\/jhep.2001.24563","article-title":"Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival.","volume":"33","author":"Yao","year":"2001","journal-title":"Hepatology"},{"key":"R25-2-20250124","doi-asserted-by":"crossref","first-page":"3543","DOI":"10.1016\/S1470-2045(08)70284-5","article-title":"; for Metroticket Investigator Study Group. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis.","volume":"10","author":"Mazzaferro","year":"2009","journal-title":"Lancet Oncol"},{"key":"R26-2-20250124","first-page":"9981011","article-title":"Consensus conference: Indications for Liver Transplantation, January 19 and 20, 2005, LyonPalais Des Congres: text of recommendations (long version).","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"R27-2-20250124","doi-asserted-by":"crossref","first-page":"262278","DOI":"10.1002\/lt.21999","article-title":"Report of a national conference on liver allocation in patients with hepatocellular carcinoma in the United States.","volume":"16","author":"Pomfret","year":"2010","journal-title":"Liver Transpl"},{"key":"R28-2-20250124","doi-asserted-by":"crossref","first-page":"7178","DOI":"10.1097\/00000658-200107000-00011","article-title":"Improved results of liver resection for hepatocellular carcinoma on cirrhosis give the procedure added value.","volume":"234","author":"Grazi","year":"2001","journal-title":"Ann Surg"},{"key":"R29-2-20250124","doi-asserted-by":"crossref","first-page":"899906","DOI":"10.1053\/he.2000.5763","article-title":"Primary liver resection and salvage transplantation or primary liver transplantation in patients with single, small hepatocellular carcinoma and preserved liver function: an outcomeoriented decision analysis.","volume":"31","author":"Majno","year":"2000","journal-title":"Hepatology"},{"key":"R30-2-20250124","doi-asserted-by":"crossref","first-page":"602611","DOI":"10.1097\/00000658-200211000-00010","article-title":"Extended hepatic resection for hepatocellular carcinoma in patients with cirrhosis: is it justified?","volume":"236","author":"Poon","year":"2002","journal-title":"Ann Surg"},{"key":"R31-2-20250124","doi-asserted-by":"crossref","first-page":"12941300","DOI":"10.1002\/lt.20202","article-title":"High pathological risk of recurrence after surgical resection for hepatocellular carcinoma: an indication for salvage liver transplantation.","volume":"10","author":"Sala","year":"2004","journal-title":"Liver Transpl"},{"key":"R32-2-20250124","doi-asserted-by":"crossref","first-page":"889896","DOI":"10.1053\/gast.2002.32418","article-title":"The association between hepatitis C infection and survival after orthotopic liver transplantation.","volume":"122","author":"Forman","year":"2002","journal-title":"Gastroenterology"},{"key":"R33-2-20250124","doi-asserted-by":"crossref","first-page":"15701579","DOI":"10.1002\/hep.24231","article-title":"Intentiontotreat analysis of liver transplantation for hepatocellular carcinoma: living versus deceased donor transplantation.","volume":"53","author":"Bhangui","year":"2011","journal-title":"Hepatology"},{"key":"R34-2-20250124","doi-asserted-by":"crossref","first-page":"700702","DOI":"10.1053\/jlts.2003.50124","article-title":"Liver transplantation for hepatocellular carcinoma: Foucault pendulum versus evidencebased decision.","volume":"9","author":"Bruix","year":"2003","journal-title":"Liver Transpl"},{"key":"R35-2-20250124","doi-asserted-by":"crossref","first-page":"533539","DOI":"10.1097\/00000658-200204000-00012","article-title":"Longterm results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 centimeters.","volume":"235","author":"Roayaie","year":"2002","journal-title":"Ann Surg"},{"key":"R36-2-20250124","doi-asserted-by":"crossref","first-page":"17611769","DOI":"10.1002\/lt.20884","article-title":"Impact of UCSF criteria according to pre and postOLT tumor features: analysis of 479 patients listed for HCC with a short waiting time.","volume":"12","author":"Decaens","year":"2006","journal-title":"Liver Transpl"},{"key":"R37-2-20250124","doi-asserted-by":"crossref","first-page":"631636","DOI":"10.1053\/jlts.2001.25458","article-title":"Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma.","volume":"7","author":"Herrero","year":"2001","journal-title":"Liver Transpl"},{"key":"R38-2-20250124","doi-asserted-by":"crossref","first-page":"391399","DOI":"10.1002\/lt.21095","article-title":"Expanded criteria for liver transplantation in patients with hepatocellular carcinoma: a report from the International Registry of Hepatic Tumors in Liver Transplantation.","volume":"13","author":"Onaca","year":"2007","journal-title":"Liver Transpl"},{"key":"R39-2-20250124","doi-asserted-by":"crossref","first-page":"13011311","DOI":"10.1002\/lt.20237","article-title":"Sirolimusbased immunosuppression for liver transplantation in the presence of extended criteria for hepatocellular carcinoma.","volume":"10","author":"Kneteman","year":"2004","journal-title":"Liver Transpl"},{"key":"R40-2-20250124","doi-asserted-by":"crossref","first-page":"13421351","DOI":"10.1053\/j.gastro.2008.02.013","article-title":"Liver transplantation for hepatocellular carcinoma: impact of the MELD allocation system and predictors of survival.","volume":"134","author":"Ioannou","year":"2008","journal-title":"Gastroenterology"},{"key":"R41-2-20250124","doi-asserted-by":"crossref","first-page":"839846","DOI":"10.1111\/j.1600-6143.2007.02138.x","article-title":"A novel model measuring the harm of transplanting hepatocellular carcinoma exceeding Milan criteria.","volume":"8","author":"Volk","year":"2008","journal-title":"Am J Transplant"},{"key":"R42-2-20250124","first-page":"851858","article-title":"; for UNOSOPTN Liver Disease Severity Score, UNOSOPTN Liver and Intestine, and UNOSOPTN Pediatric Transplantation Committees. The new liver allocation system: moving toward evidencebased transplantation policy.","volume":"8","author":"Freeman","year":"2002","journal-title":"Liver Transpl"},{"key":"R43-2-20250124","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/lt.20024","article-title":"Results of the first year of the new liver allocation plan.","volume":"10","author":"Freeman","year":"2004","journal-title":"Liver Transpl"},{"key":"R44-2-20250124","doi-asserted-by":"crossref","first-page":"3641","DOI":"10.1002\/lt.20012","article-title":"Liver transplantation for hepatocellular carcinoma: the MELD impact.","volume":"10","author":"Sharma","year":"2004","journal-title":"Liver Transpl"},{"key":"R45-2-20250124","doi-asserted-by":"crossref","first-page":"16431648","DOI":"10.1111\/j.1600-6143.2010.03127.x","article-title":"Hepatocellular carcinoma patients are advantaged in the current liver transplant allocation system.","volume":"10","author":"Washburn","year":"2010","journal-title":"Am J Transplant"},{"key":"R46-2-20250124","doi-asserted-by":"crossref","first-page":"129137","DOI":"10.1111\/j.1600-6143.2009.02750.x","article-title":"Progression of alphafetoprotein before liver transplantation for hepatocellular carcinoma in cirrhotic patients: a critical factor.","volume":"10","author":"Vibert","year":"2010","journal-title":"Am J Transplant"},{"key":"R47-2-20250124","doi-asserted-by":"crossref","first-page":"336339","DOI":"10.1016\/j.jhep.2004.06.002","article-title":"Gene expression profiles in hepatocellular carcinoma: not yet there.","volume":"41","author":"Llovet","year":"2004","journal-title":"J Hepatol"},{"key":"R48-2-20250124","doi-asserted-by":"crossref","first-page":"667676","DOI":"10.1002\/hep.20375","article-title":"Classification and prediction of survival in hepatocellular carcinoma by gene expression profiling.","volume":"40","author":"Lee","year":"2004","journal-title":"Hepatology"},{"key":"R49-2-20250124","doi-asserted-by":"crossref","first-page":"18371839","DOI":"10.1016\/S0140-6736(04)17455-2","article-title":"Predicting individual outcomes in hepatocellular carcinoma.","volume":"364","author":"Iizuka","year":"2004","journal-title":"Lancet"},{"key":"R50-2-20250124","doi-asserted-by":"crossref","first-page":"284291","DOI":"10.1016\/j.jhep.2004.04.031","article-title":"Molecularbased prediction of early recurrence in hepatocellular carcinoma.","volume":"41","author":"Kurokawa","year":"2004","journal-title":"J Hepatol"},{"key":"R51-2-20250124","doi-asserted-by":"crossref","first-page":"19952004","DOI":"10.1056\/NEJMoa0804525","article-title":"Gene expression in fixed tissues and outcome in hepatocellular carcinoma.","volume":"359","author":"Hoshida","year":"2008","journal-title":"N Engl J Med"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.22423","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.22423","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201110002-00002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T17:16:08Z","timestamp":1737738968000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201110002-00002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10]]},"references-count":51,"journal-issue":{"issue":"Supplement 2","published-print":{"date-parts":[[2011]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.22423","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2011,10]]}}}