In a much-needed move, liver transplantation specialists recently convened to address U.S. guidelines for allocation of organs for patients with hepatocellular carcinoma (HCC, liver cancer).
Representatives from more than 130 U.S. transplant centers were invited to the conference and participants included 180 leaders in liver transplantation (LT) from the 50 most active centers. Full details of the recommendations developed at the conference are published in the March issue of
Liver Transplantation, a journal of the American Association for the Study of Liver Diseases (AASLD).
The National Cancer Institute estimates that more than 16,000 men and over 6,000 women in the U.S. will be diagnosed with liver cancer, and over 18,000 liver cancer patients will succumb to the disease each year (2009). Furthermore, the United Network of Organ Sharing (UNOS) reports as many as 15,000 patients are waiting for liver transplantation, with living and deceased organ donation down by 1.7% and 1.2%, respectively (2008).
"Organs from deceased donors are considered a national resource, therefore their use should be equitable and fair, said James Neuberger, M.D., from Queen Elizabeth Hospital in the U.K and medical director of Organ Donation and Transplantation at NHS Blood and Transplant, in his editorial also published this month in
Liver Transplantation. U.S. transplant physicians agree and assembled six work groups at the conference to: standardize pathology reporting, develop specific imaging criteria, expand the Milan Criteria (MC, set of criteria used to measure tumor size to determine if a patient qualifies for LT), discuss locoregional therapy (LRT), define criteria for down-staging transplantation, and review current liver allocation system for HCC patients.
