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 answers • 11 doctors weighed in
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.
5.3k viewsReviewed >2 years ago
A Verified Doctoranswered
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.
5.2k viewsReviewed >2 years ago
Interventional Radiology 12 years experience
5.1k viewsReviewed >2 years ago
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.
4.9k viewsReviewed >2 years ago
Last updated Nov 27, 2017
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