Mazzaferro et al listed criteria for identifying a patient with a neuroendocrine tumor metastatic to the liver who may benefit from liver transplantation.




type of tumor (histology confirmed)

carcinoid tumor (low-grade neuroendocrine tumor)

high-grade neuroendocrine carcinoma, small cell undifferentiated NE carcinoma


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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