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Reassessing the role of liver transplantation for patients with metastatic colorectal cancer to the liver

Chotai, Pranit; Matsuoka, Lea

Current Opinion in Organ Transplantation: April 2019 - Volume 24 - Issue 2 - p 118–120
doi: 10.1097/MOT.0000000000000611
LIVER TRANSPLANTATION: Edited by Sophoclis P. Alexopoulos
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Purpose of review Early studies reported poor survival rates following liver transplantation for metastatic colorectal cancer to the liver and liver transplantation has thus traditionally been contraindicated for these patients. However, improvements in liver transplantation outcomes, immunosuppression and the treatment of colorectal cancer warrant a reassessment of the role of liver transplantation for metastatic colorectal cancer.

Recent findings The literature on this topic is sparse, the majority of publications being isolated cases of liver transplantation for patients with metastatic colorectal cancer to the liver. These case reports are heterogeneous, as patients received varying chemotherapy regimens and liver transplantation was performed at different times and for different indications. A prospective clinical trial out of Norway, however, has recently reported 5-year survival of 60% in a cohort of 21 patients undergoing liver transplantation for metastatic colorectal cancer to the liver. These results are significantly better than standard of care chemotherapy and comparable with outcomes for other indications for liver transplantation.

Summary The role of liver transplantation for patients with metastatic colorectal cancer to the liver needs to be further elucidated and defined by ongoing clinical trials and experience with living donor liver transplantation.

Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence to Lea Matsuoka, MD, Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, 801 Oxford House, 1313 21st Avenue South, Nashville, TN 37232, USA. Tel: +1 615 936 6528; e-mail: lea.matsuoka@vanderbilt.edu

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