The Milan criteria for liver transplantation in hepatocellular carcinoma (HCC) define patients suitable for transplant as those with:
- A Any number of nodules with total tumour diameter ≤7 cm (University of California San Francisco criteria)
- B Single HCC ≤5 cm OR ≤3 nodules each ≤3 cm, no vascular invasion, no extrahepatic disease ✓
- C Single HCC ≤7 cm without vascular invasion, regardless of number
- D Single HCC ≤3 cm in a cirrhotic liver (Child-Pugh A)
Correct answer: B. Single HCC ≤5 cm OR ≤3 nodules each ≤3 cm, no vascular invasion, no extrahepatic disease
Explanation
Milan criteria (Mazzaferro 1996): single HCC ≤5 cm, or up to 3 nodules each ≤3 cm, with no macrovascular invasion and no extrahepatic spread. Patients meeting Milan criteria have 5-year survival post-transplant of ~70% with <15% recurrence. The UCSF criteria expand this to single tumour ≤6.5 cm or ≤3 nodules with the largest ≤4.5 cm and total tumour diameter ≤8 cm. Milan remains the benchmark for UNOS/EUROTRANSPLANT listing.
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.