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Cullen et al. Hepatoma Res 2020;6:76 Hepatoma Research
DOI: 10.20517/2394-5079.2020.69

Review Open Access

Living donor liver transplantation for patients with
advanced hepatocellular carcinoma

J. Michael Cullen , Paola Vargas , Nicolas Goldaracena 1,2
1
1,2
1 Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA.
2 Division of Transplantation, Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA.
Correspondence to: Dr. Nicolas Goldaracena, Department of Surgery, University of Virginia, Health System, PO BOX 800709,
Charlottesville, VA 22908, USA. E-mail: n.goldaracena@virginia.edu
How to cite this article: Cullen JM, Vargas P, Goldaracena N. Living donor liver transplantation for patients with advanced
hepatocellular carcinoma. Hepatoma Res 2020;6:76. http://dx.doi.org/10.20517/2394-5079.2020.69
Received: 23 Jul 2020 First Decision: 24 Aug 2020 Revised: 27 Sep 2020 Accepted: 10 Oct 2020 Published: 6 Nov 2020

Academic Editor: Nobuhisa Akamatsu Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Liver transplantation (LT) is the treatment of choice for patients with hepatocellular carcinoma (HCC) and
Received: First Decision: Revised: Accepted: Published:
underlying liver disease. Given the organ scarcity, LT for patients with HCC have been restricted to those patients
Science Editor: Copy Editor: Production Editor: Jing Yu associated with the highest survivals. However, many patients with extended criteria HCC can still benefit from
LT, but due to deceased organ shortage, they are not offered that opportunity. Living donor liver transplantation
(LDLT) emerged as a successful strategy to overcome organ shortage around the world and as LDLT experience
grows, this technique might offer the opportunity to expand the indications of LT to patients with advanced HCC.
Therefore, since LDLT is not competing for deceased donor organs, many patients with extended criteria HCC who
could still benefit from transplantation may have access to this treatment option. In this review, we will discuss
the role of LDLT for patients with advanced-stage HCC and how LDLT allows for safe expansion of HCC transplant
criteria.

Keywords: Living donor liver transplantation, hepatocellular carcinoma, liver transplantation, transplant oncology,
clinical outcomes

INTRODUCTION
Hepatocellular carcinoma (HCC) is the third leading cause of death worldwide and the most common
[1,2]
primary liver cancer . Resection provides the best treatment option for disease confined to the liver.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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