Foerster F, et al. - Because hepatocellular carcinoma (HCC) recurrence is the strongest survival-limiting factor after liver transplantation (LT) in HCC patients, researchers have been studying the phenomenon of HCC recurrence after LT in a European transplantation centre over the past 20 years. Data were prospectively recorded from 304 HCC patients who had LT. After LT, 51 patients (16.8%) had a recurrence of HCC. More frequently, patients who exceeded the Milan criteria developed HCC recurrence. The time point of recurrence after recurrence did not affect survival. Furthermore, no difference was found between intra- and extrahepatic recurrence patients in survival. Patients with recurrence due to needle tract seeding, however, had a significantly better result than patients with other recurrence sites. The data supported a restrictive use of patient selection criteria to help identify patients with increased risk of HCC recurrence after LT, and highlighted the need to improve patient selection prior to LT to minimize HCC recurrence rate.