Liver Transplant Expert Forum
Will newly diagnosed HCC change MELD score?
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Will newly diagnosed HCC change MELD score?

My brother is in his late 30s.  He was diagnosed with alcoholic liver cirrhosis 4-5 years ago.  He was very sick for a year or more before being seeking treatment.  He was finally hospitalized after collapsing at home and went into a coma with encephalopathy.   He was in the hospital for several months and then a nursing home.  Eventually, he was stable enough to be discharged.  Because he has been so faithful to his medication regimen and has made all of the necessary lifestyle changes (no alcohol, etc), he has been doing pretty well and living as normal a life as possible under the circumstances.  He has been told over the years that he is not a candidate for a liver transplant because he is considered morbidly obese.  He has had a hard time losing weight.  Recently he was diagnosed with hepatocellular carcinoma.  Will this new diagnosis give him a better chance of getting on a transplant list, or will it worsen his chances for a transplant?  Would it just be his weight that would keep him from getting a transplant, or would it be a combination of the complications of his cirrhosis (he has gastroesophageal varices, ascites, portal hypertension), his weight and now the HCC?  Will the HCC increase his MELD score?  I have read that HCC can actually improve your chances of being considered for a transplant.  
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HCC will in fact prioritize someone on the list if the tumor size fits specific criteria (Milan criteria).  They will get 22 MELD points regardless of their blood tests with the potential for an ongoing increase every 3 months.  The HCC would definitely not be the reason someone wouldn't be a candidate for a transplant unless it falls ouit of the size criteria
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Thomas D Schiano, MDBlank
The Mount Sinai Medical Center
New York, NY
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