Liver transplantation for patients with hepatocellular carcinoma (HCC) within the Milan criteria
generally yields a 4-year overall survival rate of 75% and 4-year recurrence free survival rate of 83%.
But, many HCC patients present with the disease beyond the Milan criteria. On the other hands, the
overall survival of patients with advanced HCC with portal vein invasion is very poor. We report a
case
of successful living donor liver transplantation for advanced HCC with portal vein invasion by
down-staging through radioembolization, hepatic arterial infusion chemotherapy, and stereotactic
body radiation therapy.