Liver transplantation for unresectable colorectal liver metastasis

Abstract

The rapid progression in the development of liver transplantation during the last decade is largely attributed by the standardization of operative techniques (1,2) and advances in the pharmacokinetics of immunosuppressive therapy (3). Such improvements in the perioperative management have rendered liver transplantation a safer operation and in turn translated into better long-term survival (4,5). As such, the indication for liver transplantation has been expanded to include malignant liver tumor other than liver cirrhosis. Since the proposal of Milan criteria by Professor Mazzaferro in the late 1990s, liver transplantation has been universally adopted as the curative treatment for early staged hepatocellular carcinoma (HCC) in patients with liver cirrhosis (6). As a result, the 5-year overall survival rate has reached up to 70% in various series (7,8). More importantly, the introduction of Milan criteria has since revolutionized the indications for transplantation and the allocation policy for cadaveric organs.