Mazzaferro et al listed criteria for identifying a patient with a neuroendocrine tumor metastatic to the liver who may benefit from liver transplantation.
Parameter
Indication
Contraindication
type of tumor (histology confirmed)
carcinoid tumor (low-grade neuroendocrine tumor)
high-grade neuroendocrine carcinoma, small cell undifferentiated NE carcinoma
site
drained by the portal system (see below)
not drained by portal system
primary tumor
curative resection at surgery separate from transplant
hepatic involvement by metastases
<= 50% of liver
status in 6 months prior to transplant
good response or stable disease
clinical condition
<= 55 years of age and no serious comorbid conditions
> 55 years or comorbid conditions contraindicating liver transplant
Appropriate tumors:
(1) pancreas
(2) gastrointestinal tract from distal stomach to sigmoid colon
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