Liver Transplant for Cholangiocarcinoma

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Transplant surgery

Background:

• Perihilar cholangiocarcinoma (CCA) is a challenging biliary tract cancer.
• Liver transplantation (LT) is a potential curative option for select unresectable CCA.
• Survival outcomes vary based on CCA subtype and patient comorbidities.

Purpose of the Study:

• To review the role of liver transplantation in managing perihilar cholangiocarcinoma.
• To discuss neoadjuvant therapy followed by LT for CCA.
• To present early data on LT for intrahepatic CCA (ICC).

Main Methods:

• Review of existing literature on LT for CCA.
• Analysis of survival data for LT recipients with CCA.
• Discussion of treatment strategies including neoadjuvant therapy.

Main Results:

• Five-year survival rates after LT for CCA range from 65% to 70%.
• Patients with primary sclerosing cholangitis (PSC) show higher survival post-LT.
• Early data suggest favorable outcomes for very early intrahepatic CCA (ICC) treated with LT.

Conclusions:

• Liver transplantation is a viable option for carefully selected patients with unresectable CCA.
• LT outcomes are influenced by CCA origin and patient factors like PSC.
• Further research is warranted for LT in early ICC and post-neoadjuvant therapy settings.