Liver transplantation (LT) remains one of the most effective treatments for hepatocellular carcinoma (HCC) and significantly enhances patient survival. However, the application of LT for HCC faces challenges owing to advancements in cancer-specific treatment modalities and the increased burden of patients’ comorbidities. This narrative review explores current controversies and advancements in LT for HCC. Key areas of focus include the management of comorbidities and patient education by advanced practice nurses, impacts of frailty on waitlists and post-LT outcomes, selection criteria for LT in the era of new downstaging tools, role of radiology in patient selection, and implications of potential immunotherapy use both before and after LT. Additionally, the importance of immunosuppression management with strategies aimed at minimizing rejection while considering the risk of HCC recurrence and the role of surveillance for HCC recurrence is highlighted. This review also underscores the importance of a multidisciplinary approach for optimizing outcomes in patients with HCC undergoing LT.
肝移植仍是治疗肝细胞癌最有效的方法之一，能显著提高患者生存率。然而，随着肿瘤特异性治疗手段的进步及患者合并症负担的加重，肝移植在肝细胞癌治疗中的应用面临挑战。本文综述了当前肝细胞癌肝移植领域的争议与进展，重点关注以下方面：高级实践护士对合并症的管理及患者教育、衰弱状态对移植等待名单及移植后结局的影响、新型降期治疗时代肝移植的筛选标准、影像学在患者选择中的作用、免疫疗法在移植前后应用的潜在意义。此外，本文强调了免疫抑制管理策略的重要性，即在考虑肝细胞癌复发风险的同时最大限度降低排斥反应，并探讨了肝细胞癌复发监测的作用。本综述亦强调多学科协作对优化肝细胞癌肝移植患者临床结局的重要意义。
Challenges in Liver Transplantation for Hepatocellular Carcinoma: A Review of Current Controversies
肿瘤(癌症)患者之家