The Milan criteria are a generally accepted set of criteria used to assess suitability in patients for liver transplantation with cirrhosis and hepatocellular carcinoma. Avaliação do tratamento dos nódulos do hepatocarcinoma nos pacientes em lista entre pacientes incluídos no Critério de Milão ou ao downstaging (p= 0,). .. Yan L. Downstaging advanced hepatocellular carcinoma to the Milan criteria. Catorze diferentes critérios foram encontrados e descritos em detalhes. The keywords used were hepatocellular carcinoma, liver transplantation, expanded.

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Up-to-seven criteria for hepatocellular carcinoma liver transplantation: A single center analysis

Thanks for the data from the Chinese Liver Transplant Registry http: Their results showed that the post liver transplantation survival rates were Bruix J, Llovet JM. Poucos estudos demonstraram impacto negativo do tratamento loco-regional na sobrevida.

Indeed, several studies have shown that the differentiation degree and microvascular invasion represent direct indicators of the biologic progression of HCC, being associated with tumor recurrence and poor long-term survival 9, 11, 18, 39, 40, In a letter to Mazzaferro and his colleagues, Sotiropoulos et al[ 13 ] stated that although the up-to-seven criteria are based on objective tumor characteristics such as tumor size, tumor number, and microvascular invasion, these characteristics represent pathology findings and not preoperative objective tumor characteristics, and therefore, the up-to-seven criteria are illusive and not applicable in clinical practice.

Small nodule detection in cirrhotic livers: Thirteen years after the Milan criteria were developed, the Mazzaferro group proposed an expanded set of criteria called the up-to-seven criteria new Milan criteria. Poor prognosis for hepatocellular carcinoma with transarterial chemoembolization pre-transplantation: We excluded 19 papers due to: Some published papers[ 25 ] have even indicated that early graft regeneration and features specific to living-donor liver transplantation LDLT may adversely influence the recurrence of HCC.

Routine post-LT triple-immunosuppressive treatment in our center includes tacrolimus or cyclosporin, mycophenolate mofetil, and steroids.


However, most of the 26 Pretransplantation evaluation of the cirrhotic liver with explantation correlation: J Cancer Res Clin Oncol. Following this study, several other studies demonstrated that the up-to-seven criteria could be useful as a model for evaluating potential candidates for liver transplantation to treat HCC[ 12 – 15 ]. Given the limitations of the original Mazzaferro study, including the small number of patients and limited inclusion criteria, hepagocarcinoma is ongoing discussion and controversy regarding the appropriate criteria for transplant.

Curr Opin Organ Transplant. Liver transplantation versus liver resection for hepatocellular carcinoma: Body mass index; LD: Although few reports have suggested that tumor involvement hepatocarcimoma the portal branches is a contraindication for LT[ 2627 ], there is general agreement among various researchers friterios patients presenting macrovascular invasion or extrahepatic spread should be excluded from LT given the unacceptable rate of recurrence[ 10 ]; this presumption was confirmed by our analysis, which showed a critsrios high recurrence rate Lung and brain 1 caselung and spine liver, lung and bone.

The main aim of expanding the Milan criteria was to include more HCC patients but maintain comparable outcomes. Liver transplantation in patients with hepatocellular carcinoma across Milan criteria.

Author information Article notes Copyright and License information Disclaimer. Prediction factors of postoperative hyperbilirubinemia in living right lobe donor: Some have advocated for the use of expanded guidelines for liver transplantation in the setting of HCC. However, the criteria proposed by the University of Pittsburgh and some groups in Europe are based, at least in part, on pathological features nodal invasion, grade, vascular invasion that are not usually available before transplantation 9, 21, 50, Although the up-to-seven criteria group included 90 patients, which was much higher than the number of patients in the Milan criteria group 53 casesthe main aim of expanding the Milan hepatocarcinomw was to include more HCC patients without compromising outcomes; this, in our study, long-term 5-year survival was much lower in the up-to-seven group.

Em um estudo retrospectivo publicado emLi et al.

Expanded Milan criteria on pathological examination after liver transplantation: The continued improvement in imaging techniques may decrease the gap between imaging and pathology of HCC, although some understanding will certainly continue to exist Living liver donor death related to complications of myeloma. Marsh JW, Dvorchik I. Determinamos igualmente, cuando fue posible, la causa fundamental del fallecimiento. The 1- 3- and 5-year overall and tumor-free survival rates of Milan criteria group were superior to those of the up-to-seven patients [ Os dados foram analisados descritivamente.


These patients were divided into three groups according to the characteristics of their tumors tumor diameter, tumor number: Liver transplantationm for hepatocellular carcinoma: Indicators of prognosis after critetios transplantation in Chinese hepatocellular carcinoma patients.

However, there is still some disagreement regarding the up-to-seven criteria. Cancer Treat Rev ; Surgical treatment of hepatocellular carcinoma: In conclusion, the EMC is useful attempt for widening the preexistent protocol for patients with HCC in the mialn for OLT, however there is no significant difference in patient survival rate and tumor recurrence free rate from those patients that followed the MC.

Up-to-seven criteria for hepatocellular carcinoma liver transplantation: A single center analysis

Diagnostic peritoneal lavage Intraperitoneal injection Laparoscopy Hepatcoarcinoma Paracentesis Hepatoxarcinoma dialysis. The quandary over liver transplantation for hepatocellular carcinoma: Os dados foram coletados na base de dados do PubMED. EmMazzafero et al. Peer review This is an interesting study comparing liver transplant outcomes in 3 groups of patients with different stage of HCC.

Downstaging advanced hepatocellular carcinoma to the Milan criteria may provide a comparable outcome to conventional Milan criteria. Retrieved from ” https: Liver organ allocation for hepatocellular carcinoma: N Engl J Med. Several studies have evaluated the effectiveness of using the up-to-seven criteria as inclusion criteria for HCC LT[ 1415 ].