1. Liver transplantation for cholangiocarcinoma.
- Author
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Schwartz JJ, Hutson WR, Gayowski TJ, and Sorensen JB
- Subjects
- Bile Duct Neoplasms mortality, Bile Duct Neoplasms pathology, Bile Ducts, Intrahepatic pathology, Chemotherapy, Adjuvant, Cholangiocarcinoma mortality, Cholangiocarcinoma pathology, Health Services Accessibility, Humans, Neoadjuvant Therapy, Patient Selection, Practice Guidelines as Topic, Radiotherapy, Adjuvant, Severity of Illness Index, Tissue Donors supply & distribution, Treatment Outcome, Waiting Lists, Bile Duct Neoplasms surgery, Bile Ducts, Intrahepatic surgery, Cholangiocarcinoma surgery, Liver Transplantation
- Abstract
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.
- Published
- 2009
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