Medical Oncologist
CION Cancer Clinics
Liver transplant for liver cancer: who it is for | CION Cancer Clinics
A liver transplant is for a small group of people with early primary liver cancer whose liver is too damaged by cirrhosis for surgery. It can treat the cancer and the cirrhosis together. Eligibility depends on the size and number of tumours, whether they have spread, and your overall fitness. This page explains who qualifies, how donors work in India and Telangana, and who it does not suit. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed October 2026, next review due October 2027
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On this page
- Who is a liver transplant for in liver cancer?
- What decides whether I can have a transplant?
- What happens if transplant might be an option?
- How is a living donor transplant different from a deceased donor one?
- Who is a liver transplant not suitable for?
- What this page cannot tell you
- Common questions about liver transplant for cancer
The short answer
Who is a liver transplant for in liver cancer?
A liver transplant is for a small group of people with primary liver cancer (hepatocellular carcinoma, or HCC) whose tumours are few and small but whose liver is too scarred by cirrhosis to survive an operation that removes part of it. For them, replacing the whole liver can treat the cancer and the cirrhosis together, with curative intent.
Why it is not offered to everyone
A new liver only helps if the cancer has not already escaped the old one. If cancer cells have spread into blood vessels or beyond the liver, they will grow again, and the medicines that stop the body rejecting the new liver can help them grow faster. That is why teams select patients very carefully.
Which liver cancer this page is about
This page is about primary liver cancer. Cancer that has spread to the liver from the bowel, breast or elsewhere is a different illness, and transplant is not a standard treatment for it. If that is your situation, start with what secondary liver cancer means.
Being suitable for transplant is decided by a licensed transplant centre, after a full assessment.What the team weighs
What decides whether I can have a transplant?
Three things are looked at together: the cancer, the liver and the person.
The size and number of tumours
Most centres start from the Milan criteria, a set of limits on tumour size and number. In plain words, that means one tumour no bigger than a lemon, or up to three small ones. Some centres accept slightly more, under wider rules. See the Milan criteria explained.
Whether the cancer has spread
The tumour must not have grown into the main blood vessels of the liver or spread to lymph nodes, lungs or bones.
Scans that check this
- Triple-phase CT or MRI of the liver
- CT of the chest
- Sometimes a bone scan or PET-CT
How the liver is working
Blood tests such as bilirubin, albumin and INR show how badly cirrhosis is affecting you. These feed into the Child-Pugh and MELD scores that transplant teams use.
Your overall fitness
Heart, lungs, kidneys, muscle strength, other illnesses and support at home all matter. A transplant is a major operation with lifelong follow-up afterwards.
Not sure whether this applies to you?
Ask an oncologistFrom scan to decision
What happens if transplant might be an option?
The tumour board reviews your scans
Your scans and blood tests are reviewed by a multidisciplinary team. At CION, the tumour board looks at whether transplant, surgery, ablation or TACE fits your cancer and your liver.
Referral to a licensed transplant centre
If transplant looks possible, CION coordinates a referral to a licensed transplant centre. Only that centre can decide whether to list you or plan a living donor operation.
A full transplant assessment
Expect many tests, a review by hepatologists, surgeons and anaesthetists, and a social and psychological assessment. Our page on the transplant assessment lists them.
Treatment to control the tumour while you wait
Many people have TACE or ablation to stop the tumour growing during the wait. This is called bridging therapy. Sometimes it also shrinks a tumour back inside the limits, which is called downstaging.
Living donor or the waiting list
The liver comes either from a living relative who gives part of theirs, or from a deceased donor through the state allocation system.
Side by side
How is a living donor transplant different from a deceased donor one?
Living donor
Deceased donor
Most liver transplants in India are done this way
Organs are fewer, so the wait is uncertain
A healthy relative gives part of their liver
The whole liver comes from a person who has died
The donor faces real surgical risk, including a small risk of death
No living person is put at risk
Timing can be planned once both are assessed
In Telangana, allocation runs through Jeevandan
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Honest limits
Who is a liver transplant not suitable for?
Transplant is usually not offered when the cancer has grown into the main blood vessels of the liver, has spread outside the liver, or is far beyond the size and number limits even after treatment to shrink it. It is also not usually suitable when another serious illness makes the operation too dangerous.
When the liver is still working well
If you do not have cirrhosis, or your liver function is good, a surgeon may be able to remove the tumour instead. Ablation can also treat a very small tumour with curative intent. Transplant is kept for people who cannot have those options. See who is not eligible for a liver transplant.
About alcohol
If alcohol played a part in your cirrhosis, transplant centres will ask about it and usually need a period without drinking. This is a medical requirement, not a judgement. Telling your doctors the truth helps them help you.
Being straight with you
What this page cannot tell you
It cannot tell you whether you are eligible. That needs a licensed transplant centre to see your scans, blood tests and fitness. It also cannot tell you how long a wait would be, or what your own outlook after a transplant would be. Your transplant team is the right place for that conversation.
The rules change
As of 2026, deceased donor livers in Telangana are allocated through the Jeevandan programme, under national rules set with NOTTO. These rules are revised from time to time, so check the current position with the transplant centre. Nobody outside that system, including CION, can move you up the list.
About donors
Donating part of a liver is a serious decision with real risk to a healthy person. It must be the donor's free choice. Buying or selling organs is illegal in India.
If you are unsure whether transplant has been properly considered, ask for your case to be reviewed by a tumour board.Questions we are asked
Common questions about liver transplant for cancer
Can a liver transplant treat liver cancer?
For carefully selected people with early primary liver cancer and cirrhosis, yes. A transplant removes the tumour and the scarred liver that would otherwise keep producing new tumours. It is done with curative intent, but it suits only a small group, and a transplant centre decides who.
Does CION do liver transplants?
No. Liver transplants are done only at licensed transplant centres. CION's tumour board reviews whether transplant is worth considering, coordinates the referral, and continues cancer care and surveillance planning with you before and after.
What are the Milan criteria?
They are limits on tumour size and number used to judge who is likely to do well after transplant. In plain words, one tumour no bigger than a lemon, or up to three small ones, with no spread into blood vessels or outside the liver. Some centres use wider rules.
My tumour is too big. Is transplant ruled out for good?
Not always. Treatments such as TACE can sometimes shrink a tumour back inside the limits. This is called downstaging. Whether it works, and whether a centre will then accept you, depends on how the tumour responds and stays under control.
Who can be a living liver donor?
Usually a healthy adult relative with a matching blood group, who passes a full medical and psychological assessment. The donor's safety comes first. The transplant centre and an authorisation committee check that the decision is free and legal.
Is there a risk to the donor?
Yes. The donor has a major operation, with risks of bleeding, bile leak, infection and, rarely, death. Most donors recover and their liver regrows, but nobody can promise that. A donor has the right to say no at any point.
Can cancer come back after a transplant?
It can, which is why selection is so careful and why you will have regular scans and blood tests afterwards. The anti-rejection medicines are adjusted with this risk in mind. Your transplant team will explain your follow-up plan.
Do Aarogyasri or other schemes cover a liver transplant?
Some government and insurance schemes cover part or all of a liver transplant, but the rules and limits change. Check with the transplant centre and the scheme at the time. CION can help with the paperwork for cancer care. One helpline serves every CION centre.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- MedlinePlus — Liver Transplantation
- American Cancer Society — Surgery for Liver Cancer
- Cancer Research UK — Surgery for liver cancer
- American Cancer Society — Treatment of Liver Cancer, by Stage
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
The Milan criteria explainedThe size and number limits, in plain wordsLiving donor liver transplant in IndiaHow most transplants in India actually happenWho is not eligible for a liver transplantThe reasons a centre may say noDownstaging to become transplant-eligibleIf your tumour is just outside the limits
Talk to us
Has transplant been properly considered for you?
Our tumour board can review your scans and reports and tell you whether a transplant referral is worth exploring. One helpline serves every CION centre.