Table 3

Selection criteria in liver transplantation for HCC*

Milan (MC)Single lesion ≤5 cm
Up to 3 lesions ≤3 cm
No macrovascular invasion
The benchmark of patient selection criteria in patients undergoing LT for HCC endorsed in major international guidelines
UCSFSingle ≤6.5 cm
Up to three lesions ≤4.5 cm
Sum of tumour diameter ≤8 cm
Significant overlap with MC allowing at best the expansion of LT candidate with HCC of around 5%
Up-to-7Sum of size (cm) and number of HCC nodules ≤7
No mVI
Flexible approach allowing patients with different size-and-number combinations to compete for the same survival. Online calculator at
TTV+AFPAny lesions up to TTV ≤115 cm3
AFP ≤400 ng/mL
Combined score would exclude large HCC or small one with potentially aggressive behaviour and poor post-LT outcomes
Milan+AFPScore system based Number of nodules Size of the largest nodule AFP at listing (<100; 100–1000; >1000 ng/mL)Within MC, score ≤2 predicts good survival. Patients exceeding MC with AFP <100; ≤3 nodules; ≤6 cm might be considered eligible for LT
  • *Only criteria with population/registry-based collection or meta-analysis of the current evidence are listed.

  • AFP, α-fetoprotein; HCC, hepatocellular carcinoma; LT, liver transplantation; MC, Milan Criteria; mVI, microvascular invasion; TTV, total tumour volume; UCSF, University of California San Francisco.