Liver transplantation is the best treatment option for selected patients with non-resectable hepatocellular carcinoma (HCC). In many centers, patient selection is currently performed according to Milan criteria and allowing transplantation for patients with a single HCC ≤5cm or up to 3 HCCs ≤3cm. The present thesis demonstrates that patients with more advanced HCCs, with total tumor volume ≤115cm3 and alpha-fetoprotein ≤400ng/ml, can also benefit from liver transplantation and have similarly good post-transplant outcomes. Another way of allowing transplantation to patients with more advanced HCC, is to downstage HCCs prior to listing. This option is also discussed. Adjuvant post-transplant management should be performed with the use of sirolimus, an immunosuppression drug with anti-cancer properties. This drug has an appropriate side-effect profile and improves post transplantation survival in patients with HCC. Such strategies will help including more patients for transplantation, with maintained good post-transplant survivals.