Who can have a transplant for liver cancer?

A liver transplant is an operation to remove your liver and replace it with a healthy liver from a donor

We have separate information if you are having part of your liver removed.  Your doctor might call this a liver resection or a lobectomy.

You might be able to have a liver transplant if you have:  

  • a single tumour no more than 5cm across
  • a single tumour that is 5 to 7cm across and has not grown for at least 6 months  
  • no more than 5 small tumours, each no larger than 3cm across  

A liver transplant is not an option if the cancer has grown into a blood vessel or spread outside of the liver. This is because there would still be cancer cells left behind in the body after the operation. So the operation wouldn't get rid of all the cancer.

You might not be able to have a liver transplant if you have very severe scarring of the liver (cirrhosis). Your specialist will have to decide whether you would be well enough to get through the operation and recovery period.

Assessment for a liver transplant

Before a transplant you have an assessment to check how well your liver is working and whether a transplant is the best treatment for you. You usually have these tests as an outpatient but you may need a short stay in hospital.

You have blood tests, such as liver function tests. Your specialist will look at the level of a chemical in your blood called alpha fetoprotein. If this level is too high, a transplant may not be suitable for you. You will have other tests, such as an ultrasound scan.

Having a liver transplant involves a lot of careful preparation from different health care professionals. You'll meet these people during the assessment. Take this time to ask as many questions as you want to. This helps you go into the operation feeling well prepared.

You'll have several more tests before your surgery, if you and your doctor decide to go ahead with the liver transplant. This might mean going into hospital a few days before your operation.

Waiting for a liver transplant

To have a liver transplant you need a donor liver that is a close match to your own. Unfortunately there are more people needing a liver than there are livers available. It’s possible that you will have to wait a long time.

During this time the cancer can progress, which may mean you can't have a transplant anymore. To lower this risk you might be offered other treatment. The aim is to control the cancer while you are waiting. This treatment could include:

  • treatment to destroy cancer cells (ablation)
  • chemotherapy directly into the blood vessel feeding the liver cancer and blocking off the blood supply (chemoembolisation)
  • EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
    European Association for the Study of the Liver
    Journal of Hepatology, 2018. Volume 69, Pages 182-236

  • Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    A Vogel and others
    Annals of Oncology, 2018. Volume 29, Supplement 4, Pages 238-255

Last reviewed: 
24 Nov 2021
Next review due: 
24 Nov 2024

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