Halazun KJ, Rosenblatt RE, Mehta N, et al. - In this multicenter international prognostic study, researchers sought to externally verify the New York/California score, a recently published multi-institutional US hepatocellular carcinoma (HCC) selection tool that was the first model to incorporate a dynamic α-fetoprotein response (AFP-R) and match the validated score with currently accepted HCC selection tools, namely, the Milan Criteria (MC), the French-AFP (F-AFP), and Metroticket 2.0 models. The sample consisted of 2,236 adults [1,808 were men; mean (SD) age 58.3 (7.96) years] undergoing liver transplant for HCC at 4 North American and 4 European centers. In total, 545 patients did not meet the MC. This investigation seems to externally validate the importance of AFP-R in the selection of HCC patients for liver transplant. Before transplantation, the AFP-R is one of the few truly objective measures of biological characteristics available. Incorporating AFP-R into selection criteria allows for the safe expansion of MC and other models, allowing patients with acceptable tumor biological characteristics who would otherwise be denied potential cure to receive a liver transplant.