Liver transplantation for neuroendocrine tumors: progress and uncertainty

Metastases from neuroendocrine tumors (NET) of the gastrointestinal tract, carcinoids, and endocrine pancreatic tumors (EPT) can be limited to the liver for long periods and may have slow growth. The symptoms are often related to hormone overproduction, and debulking surgery-for example, liver resection-is recommended to achieve tumor remission or symptom palliation. If liver resection is not feasible, hepatectomy and orthotopic liver transplantation (OLT) have been proposed. For EPT where the primary tumor is located in the head of the pancreas it may be advantageous to resect the primary tumor and the liver metastases en bloc and perform a multivisceral transplantation (MVTx).