Milan criteria

Given the limitations of the original Mazzaferro study, including the small number of patients and limited inclusion criteria, there is ongoing discussion and controversy regarding the appropriate criteria for transplant. Additional studies attempting to replicate outcomes of the Mazzaferro study using Milan criteria thresholds have reported slightly less favorable five-year survival statistics, ranging from 50% to 70%. Some have advocated for the use of expanded guidelines for liver transplantation in the setting of HCC. In 2003, Yao et al. reported experience at the University of California San Francisco five-year post-transplantation survival of 75% in patients with tumors as large as 6.5 cm, or up to three lesions each less than 4.5 cm with cumulative tumor burden ≤8 cm. Additional studies using these so-called "UCSF criteria" have shown favorable post transplant outcomes, although also higher rates of post transplant recurrence and higher rates of disease progression while waiting for transplant. ==See also==