Liver Transplantation for Hilar Cholangiocarcinoma

Surg Clin North Am. 2024 Feb;104(1):183-196. doi: 10.1016/j.suc.2023.09.004. Epub 2023 Oct 20.

Abstract

Hilar cholangiocarcinoma (hCCA) is an infiltrative disease that often presents with locally advanced and/or metastatic disease, with a minority of patients eligible for surgical resection. Select patients with unresectable hCCA, or patients with hCCA in the setting of primary sclerosing cholangitis, with tumors less than 3 cm and no evidence of extrahepatic disease, can be effectively treated with neoadjuvant chemoradiation followed by liver transplantation. Staging laparotomy documenting lack of occult metastatic disease, including a portal lymphadenectomy documenting no nodal metastases, is essential to achieve optimal outcomes. Overall 5 year survival among treated patients is approximately 60%.

Keywords: Hilar cholangiocarcinoma; Liver transplantation; Neoadjuvant therapy; Transplant oncology.

Publication types

  • Review

MeSH terms

  • Bile Duct Neoplasms* / surgery
  • Bile Ducts, Intrahepatic / pathology
  • Bile Ducts, Intrahepatic / surgery
  • Cholangiocarcinoma* / surgery
  • Humans
  • Klatskin Tumor* / pathology
  • Klatskin Tumor* / surgery
  • Liver Transplantation*