Liver Transplantation for Colorectal Cancer

Liver transplantation has traditionally been used for hepatocellular carcinoma and end-stage liver disease, but international experience over the past three decades has shown that highly selected patients with unresectable colorectal liver metastases and no extrahepatic disease can achieve long-term survival benefit from liver transplantation. Prospective cohorts (SECA-I, SECA-II, RAPID) and a randomized controlled trial (TransMet) have reported 5-year overall survival rates around 50-60% in this population, substantially higher than historical outcomes with chemotherapy alone, particularly when supported by rigorous multidisciplinary patient selection. Based on this evidence, a liver transplant program for patients with unresectable colorectal liver metastases has been implemented within the UC-CHRISTUS Health Network (Centro del Cáncer, Pontificia Universidad Católica de Chile), building on the institution's liver transplant program of more than 30 years and 500 cases, including living-donor transplantation. Candidates are evaluated by a multidisciplinary hepatobiliary tumor board and, if deemed appropriate, are subsequently reviewed by the institutional liver transplant committee. This study will describe the clinical course of patients undergoing liver transplantation within this program using data already collected as part of routine clinical care (demographics, pathology, imaging, laboratory results, and surgical and postoperative outcomes), together with a validated quality-of-life questionnaire, with structured follow-up for up to 5 years post-transplant. No additional experimental procedures, biological sampling, or interventions outside standard clinical practice are performed for the purposes of this study. Tumor and serologic biomarkers collected as part of routine care will also be correlated with clinical outcomes.