Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Knipe H, Hacking C, et al. Milan criteria in liver transplantation. Reference article, Radiopaedia.org (Accessed on 28 Mar 2024) https://doi.org/10.53347/rID-18972
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
The Milan criteria are used to assess suitability in patients for liver transplantation with cirrhosis and hepatocellular carcinoma (HCC) with comparable outcomes when compared to patients with liver cirrhosis but without HCC 3.
The Milan criteria are widely accepted and used, however, there is evidence that less stringent selection criteria (e.g. UCSF criteria) can result in comparable survival outcomes, particularly in patients who undergo locoregional therapy (e.g. ablation, TACE) to down-stage their disease to meet the Milan criteria 3.
Under the Milan criteria, eligibility for liver transplantation is based on the following 1,3:
single tumor with a diameter of ≤5 cm, or up to 3 tumors each with a diameter of ≤3 cm
no extra-hepatic metastases
no major vessel involvement
In addition, the severity of liver disease (determined by the Child-Pugh score) or the presence of portal hypertension may also influence the suitability for transplant ref.
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1. Kim J, Kwon C, Joh J et al. Patients with Unresectable Hepatocellular Carcinoma Beyond Milan Criteria: Should We Perform Transarterial Chemoembolization or Liver Transplantation? Transplant Proc. 2010;42(3):821-4. doi:10.1016/j.transproceed.2010.02.027 - Pubmed
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2. Schwartz M, D'Amico F, Vitale A, Emre S, Cillo U. Liver Transplantation for Hepatocellular Carcinoma: Are the Milan Criteria Still Valid? Eur J Surg Oncol. 2008;34(3):256-62. doi:10.1016/j.ejso.2007.07.208 - Pubmed
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3. Lingiah V, Niazi M, Olivo R, Paterno F, Guarrera J, Pyrsopoulos N. Liver Transplantation Beyond Milan Criteria. J Clin Transl Hepatol. 2020;8(1):69-75. doi:10.14218/JCTH.2019.00050 - Pubmed
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