Role of positron emission tomography/computed tomography in living donor liver transplantation for hepatocellular carcinoma

Living donor liver transplantation (LDLT) has been established as an effective treatment for hepatocellular carcinoma (HCC) in the era of a critical shortage of deceased donors (1). For selecting appropriate the patients with HCC for liver transplantation (LT), many criteria were suggested based on tumor morphology including size and number (2,3). The representative criteria were the Milan criteria (a solitary tumor no more than 5 cm in diameter, or two or three tumors no more than 3 cm in diameter, no extrahepatic metastasis and major vessel invasion) and the University of California at San Francisco (UCSF), (a solitary tumor no more than 6.5 cm in diameter or two or three tumors with the largest diameter being no more than 4.5 cm and the sum of the diameters being no more than 8 cm, no extrahepatic metastasis and major vessel invasion). In recent, these criteria have been widely accepted to selecting patients with HCC waiting deceased donor LT. However, in Asian countries such as Korea and Japan, the LDLT has become an important option for treatment in patients with HCC, and the amount of experience and evidence on LDLT for HCC has been increased (1,4). The selection criteria for LT have gradually been expanded in large-volume centers, and the good outcome of LDLT for advanced HCC has been reported (5-7)