Proposal of a novel MELD exception point system for hepatocellular carcinoma. Dynamics better than tumor characteristics?

We read with great interest the paper published by Bhat et al., focusing on the proposal of a new model for end-stage liver disease (MELD) exception point system for hepatocellular cancer (HCC) patients waiting for liver transplantation (LT) [1]. The authors must be congratulated for their very interesting results. In view of the potential application of this model also in a European setting, we noted that 76% of the entire HCC population was treated with any type of loco-regional treatment (LRT) and that the median waiting time (WT) was 8.6 months. Consequently, the studied population is very similar to the European one, in which a high percentage of HCC patients waiting for LT undergoes LRT and has a median WT of over six months [2]