The Milan criteria are used to select hepatocellular carcinoma patients for liver transplantation. A patient meets Milan criteria if they have:

• A Single HCC nodule ≤5 cm, OR up to 3 nodules each ≤3 cm, with no vascular invasion or extrahepatic spread ✓
• B Up to 5 nodules ≤5 cm each, OR 1 nodule ≤5 cm
• C Any number of nodules provided total tumor burden ≤7 cm (up-to-7 criteria)
• D Single HCC nodule ≤3 cm with AFP <400 ng/mL and no satellite lesions

Explanation

The Milan criteria (Mazzaferro et al., NEJM 1996) define transplantation eligibility for HCC as: single tumor ≤5 cm diameter, OR up to 3 tumors each ≤3 cm, with no macrovascular invasion and no extrahepatic disease. Transplantation within Milan criteria yields 5-year survival of 70–75% and recurrence-free survival of ~83%, comparable to transplantation for non-malignant indications. The UCSF criteria and UPTO-7 criteria are expanded criteria developed subsequently to capture additional patients with favorable outcomes, but Milan criteria remain the international standard endorsed by UNOS/OPTN.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.