Biolato M, Marrone G, Miele L, Gasbarrini A, Grieco A. Liver transplantation for intermediate hepatocellular carcinoma: An adaptive approach. World J Gastroenterol 2017; 23(18): 3195-3204 [PMID: 28566879 DOI: 10.3748/wjg.v23.i18.3195]
Corresponding Author of This Article
Antonio Grieco, MD, Professor, Liver Transplant Medicine, Gastroenterological Area, Gastroenterological and Endocrino-Metabolical Sciences Department, Fondazione Policlinico Universitario Gemelli, Universita’ Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy. antonio.grieco@unicatt.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 14, 2017; 23(18): 3195-3204 Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3195
Liver transplantation for intermediate hepatocellular carcinoma: An adaptive approach
Marco Biolato, Giuseppe Marrone, Luca Miele, Antonio Gasbarrini, Antonio Grieco
Marco Biolato, Giuseppe Marrone, Luca Miele, Antonio Gasbarrini, Antonio Grieco, Liver Transplant Medicine, Gastroenterological Area, Gastroenterological and Endocrino-Metabolical Sciences Department, Fondazione Policlinico Universitario Gemelli, Universita’ Cattolica del Sacro Cuore, 00168 Roma, Italy
Author contributions: Biolato M, Marrone G and Miele L performed bibliographic research and wrote the paper; Gasbarrini A and Grieco A revised the paper for important intellectual contribution.
Conflict-of-interest statement: The authors declare no conflict of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonio Grieco, MD, Professor, Liver Transplant Medicine, Gastroenterological Area, Gastroenterological and Endocrino-Metabolical Sciences Department, Fondazione Policlinico Universitario Gemelli, Universita’ Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy. antonio.grieco@unicatt.it
Telephone: +39-6-30155451 Fax: +39-6-35502775
Received: January 28, 2017 Peer-review started: February 6, 2017 First decision: February 23, 2017 Revised: March 12, 2017 Accepted: April 12, 2017 Article in press: April 12, 2017 Published online: May 14, 2017
Core Tip
Core tip: Hepatocellular carcinoma is an increasing indication for liver transplantation, but the selection of patients is challenging because of organ shortages. Conventional Milan criteria is the reference for the selection of patients worldwide, but many expanded criteria have also demonstrated satisfactory results. Correct staging should include surrogate markers of biological aggressiveness. Additionally, successful down-staging can help select patients with a more favorable biology. Allocation rules are adjusted to minimize the imbalance between the priorities of candidates with and without hepatocellular carcinoma. Recently, a benefit-oriented “adaptive approach” was proposed, in which the selection and allocation of patients are based on their response to treatments.
