Liver transplantation for tumor entities

Area of Science:

• Hepatobiliary surgery
• Transplant oncology
• Gastroenterology

Background:

• Tumor entities are an increasing indication for liver transplantation (LT).
• Transplant oncology faces contentious indications for LT.
• Careful patient selection is paramount for successful outcomes.

Purpose of the Study:

• To review contentious indications for liver transplantation in transplant oncology.
• To evaluate the efficacy of LT for specific tumor types.
• To discuss future directions in LT for oncological indications.

Main Methods:

• Review of current literature on LT for liver metastases and primary liver cancers.
• Analysis of patient selection criteria and outcomes.
• Evaluation of neoadjuvant protocols and molecular profiling.

Main Results:

• LT for colorectal cancer liver metastases (CRLM) shows promising long-term outcomes and quality of life, despite recurrence.
• LT for intrahepatic cholangiocarcinoma (iCCA) is feasible in selected cases, with acceptable survival.
• LT for perihilar cholangiocarcinoma (pCCA) using neoadjuvant protocols yields superior long-term outcomes compared to benchmarks.

Conclusions:

• Preliminary results for LT in oncology are promising.
• Prospective trials are essential to establish routine clinical practice.
• Molecular profiling and targeted therapies will personalize LT approaches, necessitating evolving allocation systems.