Expanding Indications in Transplant Oncology.

Area of Science:

• Oncology
• Hepatology
• Transplantation Surgery

Background:

• Liver transplantation is the sole curative option for cirrhosis and hepatocellular carcinoma (HCC).
• Its application is expanding to include other primary and secondary liver malignancies.
• Evolving oncological strategies for HCC also influence transplantation candidacy.

Purpose of the Study:

• To review evidence supporting expanded indications for liver transplantation in liver cancer.
• To assess the evolving selection criteria for liver transplantation in oncologic cases.
• To highlight the role of transplantation in managing diverse primary and secondary liver tumors.

Main Methods:

• Systematic literature review of oncologic indications for liver transplantation.
• Analysis of evidence for expanded criteria in hepatocellular carcinoma (HCC).
• Evaluation of transplantation utility for colorectal cancer liver metastasis (CRLM), cholangiocarcinoma (CCA), and neuroendocrine tumors (NETs).

Main Results:

• Transplantation is increasingly recognized for treating various liver cancers beyond HCC.
• Evidence supports broader patient selection for liver transplantation in HCC.
• Colorectal cancer liver metastasis, cholangiocarcinoma, and neuroendocrine tumors are emerging indications.

Conclusions:

• Liver transplantation indications are expanding for primary and secondary liver tumors.
• Updated oncological strategies necessitate revised selection criteria for liver transplantation.
• Transplantation offers a viable treatment pathway for an increasing range of liver malignancies.