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Liver Transplantation for the Treatment of Hepatocellular Carcinoma

  • Aileen MarshallEmail author
Chapter

Abstract

Liver transplantation is established as an effective treatment for chronic liver diseases. HCC is a common complication of liver cirrhosis. Early stage HCC can be treated by liver transplantation with excellent outcomes, whereas advanced HCC has a poor prognosis. Criteria based on size and number of HCC are commonly used to identify patients likely to benefit from liver transplantation; however, even in highly selected patients HCC recurrence may still occur.

Strategies to refine patient selection to minimise the risk of recurrence include pre-transplant serological markers such as AFP or DCP and response to locoregional treatment. Downstaging of more advanced HCC using locoregional treatment may allow these patients to access transplantation with a good outcome. Novel biomarkers such as circulating tumour DNA, circulating cancer cell or non-coding RNA are areas of active research. Advances in organ retrieval using machine perfusion may also expand the donor pool and improve post-transplant graft function in patients receiving marginal donor organs, which are more frequently offered to patients with HCC. The role of novel systemic therapies in treatment of post-transplant recurrence is yet to be established.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.The Sheila Sherlock Centre for Hepatology and Liver TransplantationThe Royal Free HospitalLondonUK

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