The review by Zimmerman et al is important and timely in furthering our awareness of deficiencies in the current staging and allocation system for liver transplantation in the presence of HCC. While there is a consensus within the transplant community that the current pTNM staging system (and therefore the United Network for Organ Sharing and Milan criteria, which are based on this system) is not predictive of HCC recurrence after liver transplantation, little has been done to rectify the situation.