Liver allocation for hepatocellular carcinoma: A European center policy in the pre-MELD era

Matteo Ravaioli, Gian Luca Grazi, Giorgio Ercolani, Matteo Cescon, Massimo Del Gaudio, Matteo Zanello, Giorgio Ballardini, Giovanni Varotti, Gaetano Vetrone, Francesco Tuci, Augusta Lauro, Giovanni Ramacciato, Antonio Daniele Pinna

Research output: Contribution to journalArticlepeer-review


Background. Policies to decrease dropout during waiting time for liver transplantation (LT) are under debate. Methods. We evaluated the allocation system from 1996 to 2003, when recipients had priority related to Child-Pugh score and donors >60 years were mainly offered to recipients with hepatocellular carcinoma (HCC). The outcomes of 656 patients with chronic liver disease (142 HCC and 514 non-HCC) listed for LT were prospectively evaluated, considering recipient and donor features. Results. Transplantation and dropout rates were similar between HCC and non-HCC patients: 64.1% vs. 70.6% and 26% vs. 22.6%. Multivariate analysis showed the probability of being transplanted within 3 months was related to Child-Pugh score >10 and to HCC, whereas the probability of being removed from the list within 3 months was only related to Child-Pugh score >10. HCC patients had a lower median waiting time (97 vs. 197 days, P 60 years (50.5% vs. 33.5%, P 60 years affected outcome after LT in the non-HCC group, but not in the HCC patients. Conclusion. By allocating donors >60 years mainly to HCC patients, we controlled dropout without affecting their survival and the outcome of non-HCC patients.

Original languageEnglish
Pages (from-to)525-530
Number of pages6
Issue number4
Publication statusPublished - Feb 2006


  • Dropout
  • Hepatocellular carcinoma
  • Intention-to-treat
  • Liver allocation
  • Liver transplantation
  • Marginal graft

ASJC Scopus subject areas

  • Transplantation
  • Immunology


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