Liver transplantation for hepatocellular carcinoma (HCC) in patients with c
irrhosis is a radical treatment of the tumor and associated precancerous st
ate. It is potentially curative in a proportion of patients. The outcomes o
f early studies of liver transplantation in this indication were initially
unfavorable. Selection of transplant candidates at an early stage, in the a
bsence of extrahepatic spread, gives better survival than surgical resectio
n and alternative nonsurgical treatments. Transarterial chemoembolization c
art be used for preoperative control of the disease. Adjuvant chemotherapy
may be indicated in the postoperative period for the prevention of recurren
ce in patients with histologic features of invasiveness in the surgical spe
cimen. Liver transplantation as the treatment of choice for early HCC in sc
reening programs in cirrhotic patients may become limited by graft availabi
lity as the numbers of hepatitis C-related cases increase. Resection may be
indicated if the waiting time is likely to be long.