Liver transplantation for hepatocellular carcinoma: pre-transplant considerations and post-transplant management

Hepatocellular cancer is the seventh most frequent and third leading cause of cancer death worldwide. At its early stages, it could be amenable to complete cure using surgical resection or ablative therapies. Unfortunately, some patients present with advanced tumor stages or have reduced liver function and locoregional therapies may not be used or effective. Liver transplantation becomes an appealing option as it replaces the ailing liver and offers a chance for complete cure. Outcomes of liver transplantation for hepatocellular cancer have improved with better patient selection and adjuvant therapies allow patients to become eligible for transplantation and minimize dropouts from the waiting list. Post-transplant care, including appropriate surveillance and immunosuppression can also improve long-term outcomes with survival similar to transplantation for non-oncologic indications.