Living Donor Liver Transplantation for Colorectal Cancer Liver Metastasis

Liver transplantation (LT) for unresectable colorectal liver metastases has evolved from early feasibility studies to a biologically selected, multidisciplinary strategy for patients with liver-confined disease. Evidence from the SECA program and randomized data from TransMet support meaningful survival in carefully chosen candidates. Contemporary selection emphasizes sustained chemotherapy response, time-based observation, PET-derived metabolic burden, CEA kinetics, and extrahepatic disease. Living donor LT has expanded LT access within these established frameworks, offering elective timing and structured pathways with acceptable donor safety. Recurrence remains common, typically lung-predominant, supporting active surveillance and selective salvage.