Abstract
Background
Liver transplantation (LT) for unresectable colorectal liver metastases (CRCLM) demonstrates
good overall survival for selected patients in contemporary studies, with 5-year survival
of 80%. A Fixed Term Working Group (FTWG), set up by NHS Blood and Transplant (NHSBT)
Liver Advisory Group (LAG), advised whether CRCLM should be considered for LT in United
Kingdom. Their recommendation was that LT may be undertaken for isolated and unresectable
CRCLM using strict selection criteria as a national clinical service evaluation.
Methods
Opinions were sought from colorectal cancer/LT patient representatives, experts in
colorectal cancer surgery/oncology, LT surgery, hepatology, hepatobiliary radiology,
pathology, and nuclear medicine, and appropriate patient selection criteria, referral
and transplant listing pathways were identified.
Results
This paper summarises selection criteria for LT in United Kingdom for isolated and
unresectable CRCLM patients, and highlights referral framework and pre-transplant
assessment criteria. Finally, oncology-specific outcome measures to be utilised for
assessing applicability of LT are described.
Conclusion
This service evaluation represents a significant development for colorectal cancer
patients in United Kingdom and a meaningful step forward in the field of transplant
oncology. This paper details the protocol for the pilot study, scheduled to begin
in the fourth quarter of 2022 in United Kingdom.
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Article info
Publication history
Published online: February 20, 2023
Accepted:
February 13,
2023
Received:
November 24,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
