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Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the primary hepatic malignancies with established pathways to transplantation and model for end-stage liver disease (MELD) exception points. Other tumors managed with liver transplantation (LT) include hepatic epithelioid hemangioendothelioma and fibrolamellar HCC. LT for metastatic neuroendocrine tumor has been established with patient selection criteria and a path to MELD exception points. Additionally, recent data on LT for patients with unresectable hepatic colorectal metastases demonstrate increasingly encouraging initial results.
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http://dx.doi.org/10.1016/j.cld.2024.12.003 | DOI Listing |
Front Surg
July 2025
Department of Surgery, Division of Transplant Surgery, University of California San Diego, San Diego, CA, United States.
Liver transplantation is increasingly being explored as a treatment option for select patients with metastatic colorectal cancer (mCRC). Historically, transplantation for mCRC was abandoned due to poor long-term outcomes and high recurrence rates. However, recent advancements in patient selection, immunosuppressive strategies, and donor organ availability have led to a renewed interest in this approach.
View Article and Find Full Text PDFClin Transplant
August 2025
Department of Surgery, Dumont-UCLA Transplant and Liver Cancer Centers, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Background: Balancing the probability of transplant and waitlist dropout in patients with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) using MELD exception points has been an enduring challenge. The advent of normothermic machine perfusion (NMP) has the potential to increase access to transplantation in patients with primary hepatic malignancies.
Methods: Using the Scientific Registry of Transplant Recipients database, this study evaluated the impact of widespread availability of NMP on access to liver transplantation in transplant oncology.
Hepatol Res
June 2025
Department of Gastroenterological Surgery 1, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Aim: In 2019, expanded criteria for hepatocellular carcinoma (HCC), known as 5-5-500 (size ≤5 cm, number ≤5, alpha-fetoprotein ≤500 ng/mL), as well as Model for End-stage Liver Disease (MELD) exception, were implemented in Japan. In the present study, we evaluated liver transplantation indications and the Japanese allocation policy for HCC.
Methods: Adults with HCC were evaluated between January 2013 and December 2017 in a multicenter study in Japan.
Clin Liver Dis
May 2025
Division of Liver and Pancreas Transplantation, Department of Surgery, Dumont-UCLA Transplant and Liver Cancer Centers, David Geffen School of Medicine at University of California, Los Angeles, CA, USA. Electronic address:
Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the primary hepatic malignancies with established pathways to transplantation and model for end-stage liver disease (MELD) exception points. Other tumors managed with liver transplantation (LT) include hepatic epithelioid hemangioendothelioma and fibrolamellar HCC. LT for metastatic neuroendocrine tumor has been established with patient selection criteria and a path to MELD exception points.
View Article and Find Full Text PDFJHEP Rep
April 2025
Centre de Recherche sur l'Inflammation, Université Paris-Cité, Inserm, Paris, France.
Background & Aims: Porto-sinusoidal vascular disorder (PSVD) is a rare cause of portal hypertension. Data on hepatopulmonary syndrome (HPS) in PSVD are limited. This study aimed to determine the associated factors, plasma mediators, and evolution of HPS in patients with PSVD.
View Article and Find Full Text PDF