In liver transplantation for hepatocellular carcinoma, the Milan criteria define candidates with acceptable post-transplant recurrence rates. Milan criteria include:

• A Single HCC ≤5 cm, or up to 3 nodules each ≤4 cm, no vascular invasion
• B Single HCC ≤6 cm, or up to 5 nodules each ≤3 cm, AFP <400
• C Single HCC ≤4 cm with AFP <200, no extrahepatic disease
• D Single HCC ≤5 cm, or up to 3 nodules each ≤3 cm, no vascular invasion or extrahepatic disease ✓

Explanation

Milan criteria (Mazzaferro 1996) for liver transplantation in HCC: single tumor ≤5 cm OR up to 3 nodules all ≤3 cm each, with no macrovascular invasion and no extrahepatic disease. Patients meeting Milan criteria have 4-year survival exceeding 75% with <15% recurrence. The extended UCSF criteria allow slightly larger tumors (single ≤6.5 cm or ≤3 nodules with largest ≤4.5 cm). Down-staging protocols allow patients outside criteria to qualify after response to locoregional therapy.

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.