Transplantation for cholangiocarcinoma: when and for whom?
Liver transplantation for cholangiocarcinoma has historically been maligned. Because of a high recurrence rate and poor patient survival, the disease has been viewed as an absolute contraindication to transplantation. Based on good results using neoadjuvant and palliative radiation, a protocol for liver transplantation in selected patients with unresectable hilar cholangiocarcinoma was developed in 1993. Neoadjuvant radiation is followed by operative staging to rule out patients with lymph node metastases before liver transplantation. This approach has achieved results superior to standard surgical therapy, with 72% 5-year survival for patients with unresectable disease.
Rea
David J
DJ
Division of Transplantation Surgery, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
Rosen
Charles B
CB
Nagorney
David M
DM
Heimbach
Julie K
JK
Gores
Gregory J
GJ
D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation