Liver transplantation in malignant disease

Area of Science:

• Transplant oncology
• Hepatobiliary surgery
• Oncology

Background:

• Liver transplantation for malignant disease is a growing field within transplant oncology.
• Hepatocellular carcinoma (HCC) was the first cancer accepted for liver transplantation, with criteria evolving.
• Success in HCC has prompted exploration of liver transplantation for other primary and secondary liver cancers.

Purpose of the Study:

• To review the current evidence for liver transplantation in primary and secondary liver cancers.
• To assess the expanding indications for liver transplantation in oncology.

Main Methods:

• Literature review of studies on liver transplantation for various liver malignancies.
• Analysis of evidence supporting transplant indications for hepatocellular carcinoma, cholangiocarcinoma, and liver metastases.

Main Results:

• Liver transplantation is established for HCC, with expanding criteria.
• Evidence supports transplantation for perihilar cholangiocarcinoma and selected intrahepatic cholangiocarcinoma.
• Neuroendocrine liver metastases are an accepted indication; colorectal liver metastases show emerging evidence.
• Hepatic epithelioid hemangioendothelioma is a rare indication; hepatic angiosarcoma is generally not considered suitable.

Conclusions:

• Liver transplantation is a viable option for an increasing range of primary and secondary liver cancers.
• Further research is ongoing to refine criteria and expand the role of liver transplantation in cancer treatment.