{"entity":{"id":"liver-transplant-oncology","kind":"technology","name":"Liver transplantation for cancer (Milan criteria and beyond)","aka":[],"tldr":"Replacing the whole diseased liver cures both the cancer and the cirrhosis underneath it, for patients whose tumours are small enough.","summary":"Mazzaferro's Milan criteria (1996: one tumour ≤5 cm or up to three ≤3 cm, no vascular invasion) yield ~70% five-year survival. Expanded criteria (UCSF, up-to-seven, AFP-adjusted) and downstaging with TACE/TARE widen eligibility; living-donor transplantation (Asan Medical Center performs the world's highest volume) relieves organ shortage. Transplantation for unresectable colorectal liver metastases (TRANSMET, 2024) and perihilar cholangiocarcinoma (Mayo protocol) is expanding.","status":"standard-of-care","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Milan_criteria","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Milan_criteria"}],"tags":[],"related":[],"cancers":["hcc","cholangiocarcinoma","colorectal"],"sections":["surgery"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["asan-medical-center","mayo-clinic"],"pathways":[],"terms":["bclc-staging","child-pugh-albi"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Total hepatectomy and grafting removes the tumour and the pre-malignant cirrhotic field; immunosuppression is balanced against recurrence risk.","strengths":["Only therapy that treats cancer and cirrhosis together","Best long-term survival for early HCC"],"limitations":["Organ shortage and waiting-list dropout","Lifelong immunosuppression; checkpoint inhibitors before transplant risk rejection"],"since":1996},"route":"/technologies/liver-transplant-oncology/","neighbours":{"cancer":[{"id":"cholangiocarcinoma","kind":"cancer","name":"Biliary tract cancer (cholangiocarcinoma)","route":"/cancers/cholangiocarcinoma/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"hcc-early","kind":"cancer","name":"Early hepatocellular carcinoma (BCLC 0 and A)","route":"/cancers/hcc-early/"},{"id":"epithelioid-haemangioendothelioma","kind":"cancer","name":"Epithelioid haemangioendothelioma","route":"/cancers/epithelioid-haemangioendothelioma/"},{"id":"extrahepatic-cholangiocarcinoma","kind":"cancer","name":"Extrahepatic cholangiocarcinoma (perihilar and distal)","route":"/cancers/extrahepatic-cholangiocarcinoma/"},{"id":"hepatoblastoma","kind":"cancer","name":"Hepatoblastoma","route":"/cancers/hepatoblastoma/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"hcc-intermediate","kind":"cancer","name":"Intermediate hepatocellular carcinoma (BCLC B)","route":"/cancers/hcc-intermediate/"},{"id":"intrahepatic-cholangiocarcinoma","kind":"cancer","name":"Intrahepatic cholangiocarcinoma","route":"/cancers/intrahepatic-cholangiocarcinoma/"},{"id":"vascular-tumours","kind":"cancer","name":"Vascular tumours (angiosarcoma, epithelioid haemangioendothelioma, kaposiform haemangioendothelioma)","route":"/cancers/vascular-tumours/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"institution":[{"id":"asan-medical-center","kind":"institution","name":"Asan Medical Center","route":"/institutions/asan-medical-center/"},{"id":"mayo-clinic","kind":"institution","name":"Mayo Clinic","route":"/institutions/mayo-clinic/"}],"term":[{"id":"bclc-staging","kind":"term","name":"BCLC staging","route":"/terms/bclc-staging/"},{"id":"child-pugh-albi","kind":"term","name":"Child-Pugh and ALBI liver-function scores","route":"/terms/child-pugh-albi/"}],"idea":[{"id":"idea-hcc-io-before-transplant","kind":"idea","name":"Immunotherapy downstaging to transplant with a safe washout","route":"/ideas/idea-hcc-io-before-transplant/"}],"person":[{"id":"steve-jobs","kind":"person","name":"Steve Jobs","route":"/people/steve-jobs/"},{"id":"lee-sung-gyu","kind":"person","name":"Sung-Gyu Lee","route":"/people/lee-sung-gyu/"}],"pathway":[{"id":"organ-tropism-seed-soil","kind":"pathway","name":"Organ tropism: seed and soil","route":"/pathways/organ-tropism-seed-soil/"}],"roadmap":[{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}