Liver Transplantation for Liver and Perihilar Neoplasms

Transplantation offers curative potential for patients with select primary hepatobiliary malignancies when disease biology or hepatic reserve limit surgical resection. Contemporary practice for transplant for hepatocellular carcinoma and cholangiocarcinoma emphasizes selection through radiographic criteria, biomarker thresholds, and downstaging and neoadjuvant protocols. In carefully selected patients, transplantation is associated with increased overall survival and reduced recurrence compared to resection. Evolving allocation policies, living donor expansion, and integration of systemic therapies shape the future of liver transplant oncology.