[Current status of liver transplantation for hepatocellular carcinoma]

Hepatocellular carcinoma is the commonest primary liver tumor. It usually occurs in the setting of chronic liver disease and has a poor prognosis. Liver transplantation is the definitive therapy for early, unresectable HCC with poor liver function. After disappointing initial results, the landmark study by Mazzaferro et al. in 1996 established OLT as a suitable treatment for early HCC. Then liver transplantation achieved the best outcomes in well-selected candidates (5-yr survival of around 70%). Up to the present, various groups have attempted to expand these criteria while maintaining long-term survival rates. Even patients whose tumors were beyond Milan criteria showed better long-term survival than the reported 5-yr survival rates of 30-50% in a few large series of non-surgical treatments. Hepatic resection is the treatment of choice for HCC in non-cirrhotic patients. However, ten-year survival of the patients who underwent hepatic resection is lower than that of transplanted patients. This article reviews the expanded indications, disease recurrence and the future direction of liver transplantation for HCC.