Which of the following is not true about Milan’s criteria
**Core Concept**
Milan's criteria are a set of guidelines used to determine the suitability of patients for orthotopic liver transplantation. They were established by a team of researchers led by Dr. E. Donati in Milan, Italy, in the 1990s. These criteria aim to identify patients with hepatocellular carcinoma (HCC) who are likely to benefit from liver transplantation.
**Why the Correct Answer is Right**
Milan's criteria state that patients with HCC who meet the following conditions are considered suitable for transplantation: (1) a single tumor ≤5 cm in diameter, (2) up to three tumors, each ≤3 cm in diameter, and (3) no vascular invasion or extrahepatic spread. The criteria were developed based on the observation that patients with HCC who met these conditions had a low risk of recurrence after transplantation.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because Milan's criteria do not specify a maximum number of tumors, but rather a maximum size for each tumor (≤3 cm in diameter for up to three tumors).
**Option B:** This option is incorrect because Milan's criteria do not include a requirement for a minimum tumor size, but rather a maximum size for each tumor (≤5 cm in diameter for a single tumor).
**Option C:** This option is incorrect because Milan's criteria do not include a requirement for a specific type of vascular invasion, but rather a prohibition on any vascular invasion or extrahepatic spread.
**Clinical Pearl / High-Yield Fact**
Milan's criteria have been widely adopted as a standard for selecting patients with HCC for liver transplantation, and have been shown to be associated with improved outcomes in these patients.
**Correct Answer: D.**