Liver transplantation is the most successful treatment for limited-stage HCC. The waiting time for liver transplantation (LT) can be a critical factor affecting the oncological prognosis and outcome of patients with HCC. Efficient strategies to optimize waiting time are essential to maximize the benefits of LT and to reduce the harm of delay in transplantation. The ever-increasing demand for donor livers emphasizes the need to improve the organization of the waiting list for transplantation and to optimize organ availability for patients with and without HCC. Current progress in innovations to expand the donor pool includes the implementation of living donor LT and the use of grafts from extended donors. By expanding selection criteria, an increased number of patients are eligible for transplantation, which necessitates criteria to prevent futile transplantations. Thus, the selection criteria for LT have evolved to include not only tumor characteristics but biomarkers as well. Enhancing our understanding of HCC tumor biology through the analysis of subtypes and molecular genetics holds significant promise in advancing the personalized approach for patients. In this review, the effect of waiting time duration on outcome in patients with HCC enlisted for LT is discussed.

中文翻译：

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肝细胞癌肝移植等待时间的利与弊。

肝移植是限制期 HCC 最成功的治疗方法。肝移植（LT）的等待时间可能是影响肝癌患者肿瘤预后和结局的关键因素。优化等待时间的有效策略对于最大限度地发挥 LT 的益处并减少移植延迟的危害至关重要。对供体肝脏的需求不断增加，强调需要改善移植等待名单的组织，并优化患有和不患有 HCC 患者的器官可用性。目前在扩大捐献者库方面的创新进展包括实施活体捐献者 LT 和使用来自扩展捐献者的移植物。通过扩大选择标准，越来越多的患者有资格接受移植，这就需要制定标准来防止无效移植。因此，LT 的选择标准已经发展到不仅包括肿瘤特征，还包括生物标志物。通过分析亚型和分子遗传学来增强我们对 HCC 肿瘤生物学的理解，对于推进患者的个性化治疗方法具有重大前景。在这篇综述中，讨论了等待时间对接受 LT 的 HCC 患者预后的影响。