ILTS 2023

Liver transplantation is a crucial option for treating Hepatocellular Carcinoma (HCC) as it not only removes the tumor but also addresses underlying liver disease. Accurate prediction of post-transplantation outcomes for patients with HCC tumors exceeding MELD standards or awaiting transplantation due to donor shortages is essential to enhance surgical success rates and optimize liver allocation. At the International Liver Transplantation Society (ILTS) Annual Meeting held in Rotterdam, the Netherlands, from May 3rd to 6th, 2023, Dr. Leonardo Centonze from Niguarda Hospital in Milan, Italy, presented a recent clinical study. The study suggests that dynamic grading based on the Liver Imaging Reporting and Data System (LI-RADS) has a significant impact on preoperative outcome prediction. The research indicates that for HCC patients with multiple nodules, every nodule in the liver (not just highly suspicious lesions) should be considered for preoperative evaluation. This will influence the accuracy of liver transplantation outcome prediction.

Liver transplantation is one of the curative treatment options for hepatocellular carcinoma (HCC). However, due to the limited availability of liver donors compared to the number of patients awaiting transplantation, only a small number of HCC patients can receive liver transplantation. Previous studies have shown that local treatment before liver transplantation in HCC patients can effectively prevent tumor progression, increase the transplant rate, and reduce the postoperative recurrence rate. Transarterial chemoembolization (TACE) and ablation techniques such as radiofrequency ablation (RFA), microwave ablation, and percutaneous ethanol injection are the most commonly used bridge therapies before liver transplantation. At the International Liver Transplantation Society (ILTS) annual meeting held in Rotterdam, Netherlands, from May 3 to 6, 2023, Dr. Catherine Lamarque and her colleagues from the Henri Mondor Hospital in France reported on a clinical study (DELTAS-HCC) that showed that liver resection or thermal ablation can be effective bridges to liver transplantation for HCC and do not adversely affect patient outcomes before and after transplantation.