HCC patients who were beyond the Milan criteria showed a higher pre-transplant AFP level (p = 0.001), higher MTD (p < 0.001), higher number of tumor nodules (p < 0.001), lower DFS (p = 0.027), higher median Ki-67 index (p = 0.044), higher microvascular and macrovascular invasion (p = 0.001), higher mortality (p = 0.046), and higher recurrence (p = 0.002) than patients within the Milan criteria. The gene discussed is AFP; the disease is hepatocellular carcinoma.