Liver Transplant for Cholangiocarcinoma: A Comeback?

Liver transplant is not a standard therapy for cholangiocarcinoma; complete surgical resection of the tumor is currently the treatment of choice. Palliative options offer only short-term survival. After initial recurrence rates after liver transplant for cholangiocarcinoma in the 1990s were unacceptably high, cholangiocarcinoma has been regarded widely as a contraindication to liver transplant. Ubiquitous organ shortage further supports this conviction. Careful patient selection and a rigorous perioperative treatment by radiochemotherapy have produced some impressive survival data in specialized transplant centers in recent years. Although the graft shortage is aggravating in the Western world, the issue of liver transplant as a treatment for irresectable cholangiocarcinoma is being discussed. This review article provides an update and overview on the current status of liver transplant as a potential option for patients with irresectable cholangiocarcinoma.