Abstract: Patients with hepatocellular carcinoma who meet the requirements for liver transplantation can benefit from this treatment. The Milan standard for liver transplantation has been surpassed by the majority of hepatocellular carcinoma patients, making it challenging for them to benefit from this therapy. Hepatocellular carcinoma can be treated locally or systemically to lower its stage and patients' tumor loads, allowing more patients to qualify for liver transplantation therapy even if they now fall outside of the standard for transplant candidates. Radioembolization with ⁹⁰Y microspheres, one of the many downstaging phase treatment options, has the benefits of a small dosage and shorter treatment times, small volume targeted administration, a good tumor killing effect, and relatively low toxicity. This article will review the fundamentals of radioembolization using ⁹⁰Y microspheres, the need for downstaging prior to liver transplantation, the effectiveness and safety of radioembolization using ⁹⁰Y microspheres in downstaging prior to liver transplantation, and it's advancement in China.

Key words: Hepatocellular carcinoma, Liver transplantation, Radioembolization with 90Ymicrospheres, Downstaging