Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 05 / 13 / 2021




Hepatocellular Carcinoma: Downstaging to Liver Transplantation as Curative Therapy

Leana Frankul and Catherine Frenette*

Scripps Center for Organ Transplant, Scripps Clinic/Green Hospital, La Jolla, CA, USA
*Correspondence to: Catherine Frenette, Scripps Center for Organ Transplant, Scripps Clinic/Green Hospital, 10666 N. Torrey Pines Rd N200, La Jolla, CA 92037, USA. ORCID: Tel: +1-858-554-4310, Fax: +1-858-554-3009, E-mail:  This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(2):220-226 DOI: 10.14218/JCTH.2020.00037
Received: April 30, 2020 Accepted: March 4, 2021 Published online: March 22, 2021


Hepatocellular carcinoma (HCC) ranks among the leading cancer-related causes of morbidity and mortality worldwide. Downstaging of HCC has prevailed as a key method to curative therapy for patients who present with unresectable HCC outside of the listing criteria for liver transplantation (LT). Even though LT paves the way to lifesaving curative therapy for HCC, perpetually severe organ shortage limits its broader application. Debate over the optimal protocol and assessment of response to downstaging treatment has fueled immense research activity and is pushing the boundaries of LT candidate selection criteria. The implicit obligation of refining downstaging protocol is to ensure the maximization of the transplant survival benefit by taking into account the waitlist life expectancy. In the following review, we critically discuss strategies to best optimize downstaging HCC to LT on the basis of existing literature.


Downstaging, Milan criteria, Hepatocellular carcinoma, Liver transplantation

Journal of Clinical and Translational Hepatology 2021 vol. 9, 220-226  [ Html  ] [ PDF Full-text ]

© 2021 Authors. This is an Open Access article distributed under the terms of the  Creative Commons Attribution-Noncommercial 4.0 License(CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


You are here: Home