The Milan criteria for liver transplantation in hepatocellular carcinoma specify tumour characteristics as:
- A Single tumour ≤5 cm OR up to 3 tumours each ≤3 cm, no vascular invasion, no extrahepatic spread ✓
- B Single tumour ≤3 cm OR up to 5 tumours each ≤3 cm, no vascular invasion
- C Total tumour diameter ≤8 cm with any number of lesions
- D Single tumour ≤5 cm, AFP <400 ng/mL, no extrahepatic spread
Explanation
The Milan criteria (Mazzaferro et al., 1996) for liver transplantation in HCC are: a single tumour ≤5 cm in diameter OR up to 3 tumours each ≤3 cm, with no macrovascular invasion and no extrahepatic metastases. Patients meeting these criteria have 4-year survival rates exceeding 75% post-transplant, similar to transplantation for non-malignant indications. The University of California San Francisco (UCSF) criteria are expanded but the Milan criteria remain the standard. AFP-based criteria are newer expansions such as the AFP model but are not the original Milan criteria.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.