{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:25:52Z","timestamp":1784903152957,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,9,2]],"date-time":"2009-09-02T00:00:00Z","timestamp":1251849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hepatocellular carcinoma (HCC) is the second most common cause of male cancer death in Korea, where the major etiology, chronic hepatitis B virus infection, is endemic. With a high incidence of unresectable HCCs and a low cadaveric organ donation rate, the number of adult living\u2010donor liver transplantations (LDLTs) has increased rapidly, by tenfold, over the past 10 years, as an alternative to deceased\u2010donor liver transplantation (DDLT) in Asia, including Korea. Currently, HCC accounts for more than 40% of the indications for adult LDLT as the associated decompensation cirrhosis or unresectable HCC with 2.8% perioperative mortality at our institute. In determining eligibility for LDLT, the Milan criteria, which have a major aim of reducing the wastage of cadaveric liver grafts, still remain the gold standard. Our published results with 168 adult LDLTs show no difference from the results with DDLT for HCC that meets the Milan criteria. However, since a substantial proportion of adult LDLT patients not fulfilling the Milan criteria have been found to survive for longer than expected, and because a live donor organ is a private gift, most LDLT programs in Korea accept HCC patients beyond the Milan criteria, and the reported 3\u2010year survival rates for such patients are approximately 63%. Our new proposal for expanded criteria (Asan criteria; tumor diameter \u22645 cm, number of lesions \u22646, no gross vascular invasion) in LDLT has focused on extending the number limits but keeping the maximum tumor size at 5 cm, because even modest expansion of tumor size limits beyond the Milan criteria adversely affected survival. The overall 5\u2010year patient survival rates were 76.3 and only 18.9% within and beyond the Asan criteria, respectively; these criteria broaden the indications for patient selection and can more accurately identify patients who will benefit from LDLT than the conventional Milan criteria and the University of California at San Francisco criteria. In Asia, where the option for DDLT is minimal or negligible, LDLT with the modest expanded selection criteria will continue to provide a chance of long\u2010term survival for some patients with advanced HCC.<\/jats:p>","DOI":"10.1007\/s00534-009-0167-6","type":"journal-article","created":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T09:34:16Z","timestamp":1251797656000},"page":"539-547","source":"Crossref","is-referenced-by-count":31,"title":["Liver transplantation for hepatocellular carcinoma: Korean experience"],"prefix":"10.1002","volume":"17","author":[{"given":"SungGyu","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ChulSoo","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TaeYong","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DeokBog","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KunMoo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GiWon","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DongHwan","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GilChun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YoungDong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NamKyu","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan Medical Center Ulsan University  PoongNap\u2010Dong 388\u20101, SongPa\u2010Ku Seoul 138\u2010736 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KwanWoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hepato\u2010Biliary Surgery and Liver Transplantation, Asan 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