In renal transplantation, the Milan criteria govern listing for liver transplantation in hepatocellular carcinoma. A patient with 3 HCC nodules (1.5 cm, 2 cm, 2.5 cm) and no vascular invasion or extrahepatic spread falls within which category?
- A Within Milan criteria ✓
- B Beyond Milan but within UCSF criteria
- C Beyond both Milan and UCSF criteria
- D Within Milan criteria only if AFP <200 ng/mL
Correct answer: A. Within Milan criteria
Explanation
Milan criteria for liver transplantation in HCC: single tumour ≤5 cm, or up to 3 tumours each ≤3 cm, with no macrovascular invasion and no extrahepatic disease. This patient has 3 nodules (1.5, 2, 2.5 cm) all within 3 cm, so qualifies within Milan criteria, predicting 5-year survival >70% comparable to non-tumour transplants. AFP threshold is not part of the original Milan criteria (though new expanded criteria incorporate it).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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