Hepatocellular carcinoma is a major cause of morbidity and mortality worldwide. It ranks sixth out of all cancers and the fourth leading cause of cancer death. Liver transplantation is a key way of treating this disease, therefore, hepatocellular carcinoma grows as a primary indication for graft allocation. Although liver transplantation is a remarkable therapy for hepatocellular carcinoma, organ deficiency, careful selection and management of patients who may have a major survival benefit

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... transplantation remains a fundamental question. In fact, only some stages of the disease seem susceptible to transplantation, which stimulates discussions about the appropriate criteria for selecting candidates. In this article, we focused on the current criteria for selecting patients with hepatocellular carcinoma eligible for liver transplantation, as well as strategies to prevent disease progression and exclusion from the waiting list during waiting. Specific treatments used to reduce the stage of the disease to acceptable criteria (downstaging) are also reported when their tumor burden exceeds standard transplant criteria. Finally, we examined tumor recurrence after liver transplantation. The occurrence of recurrence is estimated at about 8% -20% in different studies. Possible approaches to prevent recurrence of the disease after transplantation are reported with appropriate results.