Liver transplantation for hepatocellular adenomas: UK NHSBT-liver advisory group guidelines for patient selection

Liver transplantation (LT) for hepatic adenomas has been described, but there are no set criteria for patient selection. A Fixed Term Working Group (FTWG), set up by the NHS Blood and Transplant (NHSBT) Liver Advisory Group (LAG), advised systematic work-up and using strict selection criteria as a national guideline.

Opinions were sought from patient representatives, expert hepatologists, histopathologists, liver transplant and hepatobiliary surgeons, and radiologists, all with expertise in adenoma management and familiarity with UK transplant pathways. The group discussed the wide range of radiological, histological, and clinical characteristics of HAs and formulated a set of core questions that address the clinical scenarios requiring consideration of liver transplantation, and thus developing appropriate patient selection criteria, referral and transplant listing pathways were identified.

This paper summarises the selection criteria for LT in United Kingdom for HAs, and highlights the investigation framework, the work-up needed prior to transplant assessment and the referral pathway for LT.

This manuscript details the protocol for the work-up, referral, streamlined and standardised selection of patients with HAs for LT and represents a significant development in the management of HA patients.