Contraindications of RFA or percutaneous thermal ablative techniques
The only absolute contraindications are uncorrectable coagulopathy or a noncompliant patient. RFA and other percutaneous ablative techniques are local treatments and are usually not performed in patients with vascular invasion or extrahepatic metastases. Patients with colonization of the biliary tract from bilioenteric anastomoses, endoscopic sphincterotomy, or bilioenteric fistula are at increased risk of postablation liver abscess. Some liver transplant centers may exclude patients from transplant consideration who have had percutaneous tumor ablation because of concerns of tumor recurrence from tract seeding, so it is important to discuss treatment options with referral hepatologists and surgeons who are experts in liver transplantation.