Colon Rectal Liver Metastases: The Role of the Liver Transplantation in the Era of the Transplant Oncology and Precision Medicine

• Main Authors: Michele Finotti, Alessandro Vitale, Enrico Gringeri, Francesco Enrico D'Amico, Riccardo Boetto, Alessandra Bertacco, Sara Lonardi, Francesca Bergamo, Paolo Feltracco, Umberto Cillo
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-07-01
• Series: Frontiers in Surgery
• Subjects: liver resection; transplant benefit; prioritization; immunosopressive therapy; recurrence
• Online Access: https://www.frontiersin.org/articles/10.3389/fsurg.2021.693387/full
• ISSN: 2296-875X

The development of liver metastases in colon rectal cancer has a strong impact on the overall survival (OS) of the patient, with a 5-year survival rate of 5% with palliative treatment. Surgical resection combined with pharmacological treatment can achieve a 5-year OS rate of 31–58%. However, in only 20% of patients with colon rectal liver metastases (CRLMs), liver resection is feasible. In highly selected patients, recent trials and studies proved that liver transplantation (LT) for non-resectable CRLM is a surgical option with an excellent long-term OS. The paper aims to review the indications and outcome of LT for CRLMs, with a special focus on immunosuppressive therapy and the management of local and extrahepatic recurrence after LT.