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    Milan Criteria for Liver Transplantation

    Assess suitability of patients for liver transplant with cirrhosis and hepatocellular carcinoma, recommended by AASLD guidelines.
    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with hepatocellular carcinoma (HCC) being considered for orthotopic liver transplant (OLT).
    • Originally developed by Mazzaferro and colleagues in Milan in 1996 to identify cirrhotic patients with early stage HCC likely to benefit from transplant.
    • Widely validated.
    • HCC as an indication for OLT was controversial before Milan Criteria were published; now it is an accepted indication and still used today in its original iteration.
    • Patients not meeting Milan Criteria at presentation can potentially be downstaged with locoregional therapy such as transarterial chemoembolization (TACE) or radioembolization with Yttrium-90 (Y90), though it is not known whether pre-transplant downstaging reduces post-transplant survival.
    • OLT cures HCC, but the procedure itself is extremely high risk.
    • The Milan Criteria identify patients most likely to benefit from transplantation.
    • Recommended by AASLD guidelines.
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    Next Steps
    Evidence
    Creator Insights
    Dr. Vincenzo Mazzaferro

    About the Creator

    Vincenzo Mazzaferro, MD, is a professor of medicine and director of the Gastrointestinal and Hepato-Pancreatic Surgery and Liver Transplantation Unit at the Istituto Nazionale dei Tumori in Milan, Italy. He is an avid researcher of liver transplantation and studies treatment of metastatic cancers to the liver and novel treatments of tumors. Dr. Mazzaferro’s research group was responsible for the development of the Milan Criteria, which has been adopted as a transplant guideline in many countries.

    To view Dr. Vincenzo Mazzaferro's publications, visit PubMed

    Are you Dr. Vincenzo Mazzaferro? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Vincenzo Mazzaferro
    Are you Dr. Vincenzo Mazzaferro?
    Guidelines