Changes in Liver Transplant Criteria for Hepatocellular Carcinoma

Purpose of Review: There have been several recent policy changes in liver transplantation for hepatocellular carcinoma (HCC). We outline the most recent changes in allocation policy for HCC prior to transplant and the rationale behind them. Recent Findings: The United Network for Organ Sharing recently adopted a new allocation policy for HCC to better balance organ availability between HCC and non-HCC waitlist candidates and exclude patients with rapidly progressive HCC. This policy includes a mandatory 6-month waiting period prior to application of model for end-stage liver disease (MELD) exception points and a cap of 34 points. Summary: The new policies have changed the landscape of liver transplantation for HCC in the USA. The allocation policy should better select HCC patients who would have the best post-transplant outcome and balance liver transplant benefits between HCC and non-HCC patients.