Sub-optimal selection of liver cancer patients for liver transplantation
Liver transplantation offers a curative-intent treatment for patients with HCC in early stages of the disease. This is a complex and costly procedure that is limited by the low availability of organs for transplantation, being offered only to patients likely to benefit from the procedure in the long term. Many criteria have been proposed over the years to identify these patients, but these are still sub-optimal: drop-out rates from transplant waiting list due to HCC progression are still significant (10-30%)1,2 and approximately 8-20% of patients that fall within the most widely used criteria (Milan) develop HCC recurrence following the procedure 3,4. On the other hand, some patient selection criteria are quite restrictive, excluding patients that could benefit from liver transplantation. While inclusive criteria are associated with increased costs and risks related to a second surgical intervention due to cancer recurrence, exclusive criteria imply the denial of a curative treatment to a patient that would benefit from it5,6. HepatoPredict is a new in vitro diagnostics test that provides solid prognostic information for HCC patients.