Selection of candidates with HCC for transplantation in the MELD era

Key Points 1 Liver transplantation is the main option for patients with early HCC who are not optimal candidates for surgical resection. 2 Shortage of donors is its main limitation, as waiting for a liver allows the tumor to progress and induce exclusion from the waiting list and death. 3 The absence of randomized controlled trials hinders the establishment of the most effective therapy to prevent tumor progression while waiting. 4 Live donation may be a cost‐effective approach if optimal results are expected and the mortality risk for the donor is kept below .3%. 5 Priority policies have to be developed and refined to provide a fair and effective distribution of cadaveric organs. (Liver Transpl 2004;10:S4–S9.)