換肝

• Indication :

  • Most : liver cirrhosis child C , Fulmunant hepatitis, Unresectable HCC but within UCSF expanded critiriae ….. -

• Waiting list　順位

  • fulmanant 優先－＞　再依據　ＭELD score 排序 (指標：Bil , Cr, INR )
  • contra-indication: 戒酒半年以內、active infection 、uncontrol cancer -

• 健保給付換肝標準

  • Milan critiria : HCC 1pc <5cm or 3pc < 3cm；　No major vascular invasion

• UCSF Expanded Criteria

  • One lesion ≦6.5 cm or 2-3 lesions, none > 4.5 cm
  • Total diameter ≦8cm No major vascular invasion