Selecting Appropriate Patients with Hepatocellular Carcinoma for Liver Transplantation

Among patients with hepatocellular carcinoma (HCC), careful selection of transplant recipients based on strict morphologic criteria has resulted in dramatically improved outcomes in recent years; 5-year survival is now 70% to 80%. However, concerns have arisen that allocation of donor livers based solely on such strict criteria might exclude some patients who could benefit from transplantation, despite not meeting Milan criteria. To address this issue, several centers have adopted protocols for HCC patient selection that incorporate tumor grade, as determined by preoperative needle core biopsy (NCB), but the validity of NCB to predict final tumor grade has not been assessed. In this large study, researchers specifically evaluated the diagno…