Table 1.

Indications and contraindications for liver transplant

Indications

Acute liver failure

Hepatic artery thrombosis within 14 days of liver transplant

Cirrhosis with:

Decompensation (variceal bleeding, hepatic encephalopathy, or ascites)

MELD score ≥ 15

Hepatopulmonary syndrome or portopulmonary hypertension (select patients)

Primary hepatic neoplasms:

Hilar cholangiocarcinoma (highly selected, after neoadjuvant therapy protocol)

Hepatocellular carcinoma within the Milan criteria

Inborn metabolic conditions:

Cystic fibrosis with concomitant lung and liver disease

Primary hyperoxaluria type I with significant renal insufficiency

Familial amyloid polyneuropathy

Contraindications

Absolute contraindications

Active extrahepatic malignancy

Intrahepatic cholangiocarcinoma

Hepatocellular carcinoma outside Milan criteria or metastatic

Severe cardiopulmonary disease

Uncontrolled sepsis

Active alcohol or illicit substance abuse

Acquired immune deficiency syndrome (AIDS)

Persistent non-compliance or lack of social support

Technical and/or anatomic barriers to liver transplantation

Relative contraindications

Advanced age

Portal venous thrombosis

Human immunodeficiency virus (HIV) infection

MELD score < 15

Morbid obesity (body mass index [BMI] ≥ 40)

Poor medical compliance or social support

Active psychiatric comorbidities