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Does a new diagnosis of hepatocellular carcinoma add points to the meld score of a cirrhosis patient? patient is going to be evaluate for transplant. hepatologist has not started testing to see if hcc is primary or a metastasis? shouldn't they be doing

4 doctor answers11 doctors weighed in
Dr. Robert Andrews
Interventional Radiology 36 years experience
HCC : Hcc is, by definition, primary in the liver. If the tumor size and quantity fit within very specific criteria, then the patient is given extra points toward transplant. However, if the tumor burden exceeds those limits or has metastasized outside of the liver, then the patient is not a candidate for transplant regardless of the meld score. If a tumor is smaller than 2 cm, it is not counted towards transplant the criteria i've mentioned are called the milan criteria. They specify the following: in order to qualify for transplant, a patient can have one hcc lesion up to 5 cm in size or as many as three hcc lesions as long as none of them is larger than 3 cm.
Dr. Nitin Ohri
A Verified Doctoranswered
A US doctor answeredLearn more
Usually: A diagnosis of hepatocellular carcinoma often adds "tumor exception points" to the meld score. Unlike most cancers, hepatocellular cancer can be diagnosed based on imaging and laboratory findings without a biopsy. A tumor usually has to reach 2 centimeters in size before it affects the meld score.
Dr. Michael Ginsburg
Interventional Radiology 12 years experience
Good questions: Where you are on the transplant list depends on how sick your liver is. To estimate the function of the liver meld score is calculated (model for end stage liver disease). The score depends on blood tests - bilirubin (pigment causing jaundice), creatinine (kidney function measure), and inr (clotting tendency of blood). Basically, higher meld score means sicker liver and higher on the list. Unos ..
Dr. Michael Ginsburg
Interventional Radiology 12 years experience
Provided original answer
UNOS allows “exception” MELD points to patients with HCC that are within the Milan Criteria placing them higher on the transplant list.
May 15, 2013
Dr. Michael Ginsburg
Interventional Radiology 12 years experience
Provided original answer
HCC is almost always diagnosed with a CT scan or MRI. These imaging studies are usually diagnostic making biopsy of the tumor unnecessary.
May 15, 2013
Dr. Mary Maluccio
Surgical Oncology 27 years experience
Possibly: Hcc in the setting of underlying liver disease can make a patient eligible for meld exception points. This is justified based on the introduction of cancer specific variables that will influence survival in a patient who would be potentially cured with liver transplant.

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Last updated Nov 27, 2017

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