摘要Patients undergoing liver transplantation for hepatocellular carcinoma(HCC)within the Milan criteria have an excellent outcome.We developed a program to analyze and prove that the Milan criteria can be expanded safely and effectively.Methods:We retrospectively reviewed 117 HCC patients treated with liver transplantation between January 2013 and December 2017.Patients were grouped according to the Milan criteria,the University of California,San Francisco(UCSF)criteria,Up-to-seven criteria and Hangzhou criteria.Tumor-free and overall survival rates were investigated with a Kaplan-Meier analysis.Multivariable regression Cox models produced survival estimates for the patients that exceeded the Milan criteria.Results:The 1-year,3-year and 5-year overall survival rates of patients fulfilling the Milan criteria(n=44)were 100％,87.5％and 78.9％,respectively.Compared with the Milan criteria,the UCSF criteria(n=50),Up-to-seven criteria(n=51)and Hangzhou criteria(n=86)provided an expansion of 13.6％,15.9％and 95.9％,respectively.The 1-year,3-year and 5-year overall survival rates of patients fulfilling UCSF criteria,Up-to-seven criteria and Hangzhou criteria were 96.0％,84.9％,76.9％;96.1％,85.2％,77.6％and 97.7％,83.9％,66.7％,respectively(P＞0.05).Multifactor Cox regression showed that tumor diameter and microvascular invasion were independent risk factors for survival in patients that exceeded the Milan criteria.Conclusion:Compared with the Milan criteria,the Hangzhou criteria can safely expand the scope of liver transplantation for HCC to a certain extent.By contrast,the UCSF criteria and Up-to-seven criteria result in a limited number of patients which need further expansion.Tumor diameter and microvascular invasion were the independent risk factors for survival in patients that exceeded the Milan criteria.