Liver Transplant Criteria for Liver Cancer

Liver transplant criteria for liver cancer vary globally, and there is currently no universally accepted standard. The Milan criteria were among the first to be widely adopted. According to these guidelines, patients are eligible if they have a single tumor no larger than 5 cm in diameter, or up to three tumors each no larger than 3 cm. Additionally, there should be no evidence of vascular invasion or distant metastasis.

In 2008, China introduced the Hangzhou criteria, which offer a more expanded approach. These criteria are divided into two categories: A and B. Category A includes patients with tumors ≤8 cm in diameter, or those with tumors >8 cm but with an alpha-fetoprotein (AFP) level ≤100 μg/mL. Category B refers to tumors larger than 8 cm with AFP levels ranging from 100 to 400 μg/mL.

The Hangzhou criteria aim to provide more flexibility in patient selection while maintaining acceptable post-transplant survival rates. They represent an important step toward refining liver transplant eligibility beyond the traditional Milan criteria. These expanded guidelines are particularly relevant in regions with limited donor availability, where maximizing transplant benefits is crucial.

Understanding these standards helps medical professionals and patients make informed decisions regarding liver transplantation. As research progresses, more tailored and effective criteria are expected to emerge.