OBJECTIVETo investigate the value and deficiency of Milan criteria for liver transplantation in patients with hepatocellular carcinoma (HCC).

METHODSBetween December 2001 and November 2005, 125 patients underwent orthotopic liver transplantation ( OLT), who measured up Milan criteria with preoperation computerized tomography (CT) scanning. The results of pre-transplant multidetector CT scan and post-transplant pathology were retrospectively analyzed, and survival rates were compared.

RESULTSPathology examination demonstrated that 97 cases met Milan criteria (77.6%), 26 cases exceeded Milan criteria,and the other 2 cases were diagnosed as nodular cirrhosis. The 1-,2-,3-,4- and 5-year survival rates for those met pre-transplant multidetector CT scanning pre-transplant met Milan criteria vs. those met post-transplant pathology post-transplant criteria were 92.0% vs. 92.8%, 87.2% vs. 90.7%, 86.4% vs. 89.7%, 86.4% vs. 89.7%, and 86.4% vs. 89.7%, respectively. There was no statistic significant difference (P > 0.05). The 1-,2-,3-,4- and 5-year survival rates were 73.0%, 65.4%, 61.5%, 61.5% and 61.5%, for those pathology exceed Milan criteria respectively. The difference between this group and each of the above two were statistically significant (P < 0.05).

CONCLUSIONSThe prognosis of OLT for HCC is good for those met Milan criteria by pre-transplant multidetector CT. Factors leading to poor prognosis such as portal vein tumor thrombi and lymphatic metastasis should be accurately evaluated avoiding for misjudgement.