Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis
Liver transplantation (LT) is considered the ideal treatment for hepatocellular carcinoma (HCC) concurrent with underlying cirrhotic liver disease. As well-known, LT for HCC based on the Milan criteria has shown satisfactory outcomes. However, numerous expanded transplantation criteria were proposed...
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Elsevier
2025-04-01
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| Series: | Biomedical Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S231941702400060X |
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| author | Kun-Ming Chan Wei-Chen Lee |
| author_facet | Kun-Ming Chan Wei-Chen Lee |
| author_sort | Kun-Ming Chan |
| collection | DOAJ |
| description | Liver transplantation (LT) is considered the ideal treatment for hepatocellular carcinoma (HCC) concurrent with underlying cirrhotic liver disease. As well-known, LT for HCC based on the Milan criteria has shown satisfactory outcomes. However, numerous expanded transplantation criteria were proposed to benefit more patients for LT and showed comparable survivals as well. In addition, a modest expansion of transplantation criteria for HCC may be acceptable on the basis of the consensus within the transplantation community. Nonetheless, LT in patients with advanced HCC and portal vein tumor thrombosis (PVTT) recently has received attention and has been reported by many transplantation centers despite being contraindicated. Of those, the LT outcomes in certain HCC patients with PVTT were favorable. Additionally, the advancement of multimodality treatments and the evolution of systemic therapies have emerged as promising therapeutic options for downstaging advanced HCC prior to LT. Somehow, advanced HCC with PVTT could be downstaged to become eligible for LT through these multidisciplinary approaches. Although the available evidence of LT for HCC with PVTT is limited, it is hoped that LT may soon be more widely indicated for these patients. Nevertheless, several unknown factors associated with LT for HCC remain to be explored. Herein, this review aimed to update the developments in LT for patients with advanced HCC. |
| format | Article |
| id | doaj-art-13ec312867e84fd1b67c2e26ce635bf7 |
| institution | Kabale University |
| issn | 2319-4170 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj-art-13ec312867e84fd1b67c2e26ce635bf72025-08-20T03:25:04ZengElsevierBiomedical Journal2319-41702025-04-0148210075710.1016/j.bj.2024.100757Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosisKun-Ming Chan0Wei-Chen Lee1Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanLiver transplantation (LT) is considered the ideal treatment for hepatocellular carcinoma (HCC) concurrent with underlying cirrhotic liver disease. As well-known, LT for HCC based on the Milan criteria has shown satisfactory outcomes. However, numerous expanded transplantation criteria were proposed to benefit more patients for LT and showed comparable survivals as well. In addition, a modest expansion of transplantation criteria for HCC may be acceptable on the basis of the consensus within the transplantation community. Nonetheless, LT in patients with advanced HCC and portal vein tumor thrombosis (PVTT) recently has received attention and has been reported by many transplantation centers despite being contraindicated. Of those, the LT outcomes in certain HCC patients with PVTT were favorable. Additionally, the advancement of multimodality treatments and the evolution of systemic therapies have emerged as promising therapeutic options for downstaging advanced HCC prior to LT. Somehow, advanced HCC with PVTT could be downstaged to become eligible for LT through these multidisciplinary approaches. Although the available evidence of LT for HCC with PVTT is limited, it is hoped that LT may soon be more widely indicated for these patients. Nevertheless, several unknown factors associated with LT for HCC remain to be explored. Herein, this review aimed to update the developments in LT for patients with advanced HCC.http://www.sciencedirect.com/science/article/pii/S231941702400060XLiver transplantationHepatocellular carcinomaPortal vein thrombosis |
| spellingShingle | Kun-Ming Chan Wei-Chen Lee Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis Biomedical Journal Liver transplantation Hepatocellular carcinoma Portal vein thrombosis |
| title | Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis |
| title_full | Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis |
| title_fullStr | Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis |
| title_full_unstemmed | Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis |
| title_short | Liver transplantation for advanced hepatocellular carcinoma: Controversy over portal vein tumor thrombosis |
| title_sort | liver transplantation for advanced hepatocellular carcinoma controversy over portal vein tumor thrombosis |
| topic | Liver transplantation Hepatocellular carcinoma Portal vein thrombosis |
| url | http://www.sciencedirect.com/science/article/pii/S231941702400060X |
| work_keys_str_mv | AT kunmingchan livertransplantationforadvancedhepatocellularcarcinomacontroversyoverportalveintumorthrombosis AT weichenlee livertransplantationforadvancedhepatocellularcarcinomacontroversyoverportalveintumorthrombosis |