Liver Transplants for Hepatocellular Carcinoma

A liver transplant replaces a diseased liver with a healthy liver from a donor. For selected patients with hepatocellular carcinoma, transplantation can treat both the cancer and the underlying cirrhosis at the same time, offering one of the best chances for long-term cure.

Who Is Eligible? The Milan Criteria

Transplant candidates with HCC are commonly evaluated using the Milan criteria: a single tumor no larger than 5 cm, or up to three tumors each no larger than 3 cm, with no spread into blood vessels or outside the liver. Some centers use expanded criteria for carefully selected patients.

The Waitlist and MELD Exception Points

Donor livers are allocated through a national system based largely on the MELD score, which measures how urgently a patient needs a transplant. Patients with HCC who meet criteria may receive MELD exception points to reflect their cancer risk while they wait. Some patients receive "bridging" treatments such as ablation or chemoembolization to control the tumor during this time.

The Transplant Process and Outlook

After transplant, patients take lifelong immunosuppressant medicines to prevent rejection and are monitored closely. For patients who meet established criteria, long-term survival after transplant for early HCC is favorable, though outcomes depend on tumor characteristics and overall health.

This page is for general education and is not medical advice. A transplant center can assess eligibility and explain the risks and benefits for your situation.