Liver transplantation for cholangiocarcinoma.
Liver transplantation for cholangiocarcinoma (CCA) remains a controversial subject. More than 15 years after, a novel protocol combining neoadjuvant chemoradiation and orthotopic liver transplantation was first used in patients with unresectable hilar CCAs, these methods have yet to reach broad application. Results have confirmed that this approach leads to significantly lower recurrence rates and higher long-term survival rates than other existing treatment modalities. Despite this, protocols to treat patients with CCA are not widespread, and are available at only a handful of transplant programs. At these centers, treatment success may ultimately hinge on regional model for end-stage liver disease scores and waiting time for transplant. While acknowledging these factors as well as a severe organ shortage, it is important that the transplant community not overlook a potentially effective form of therapy for a previously untreatable disease.
Schwartz
Jason J
JJ
Department of Surgery, University of Utah, Salt Lake City, 30 N 1900 E, Salt Lake City, UT 84132, USA. Jason.Schwartz@hsc.utah.edu
Hutson
William R
WR
Gayowski
Timothy J
TJ
Sorensen
John B
JB
D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006297:Health Services Accessibility; D006801:Humans; D016031:Liver Transplantation; D020360:Neoadjuvant Therapy; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018714:Radiotherapy, Adjuvant; D012720:Severity of Illness Index; D014019:Tissue Donors / Q000600:supply & distribution; D016896:Treatment Outcome; D014850:Waiting Lists