Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, with the liver being the most common site of metastatic spread. While surgical resection represents the only potentially curative treatment for colorectal liver metastases (CRLM), the majority of patients present with unresectable disease and are managed with systemic chemotherapy, which offers limited long-term survival.
In recent years, liver transplantation (LT) has re-emerged as a promising therapeutic strategy for highly selected patients with unresectable CRLM. Advances in patient selection, perioperative management, and oncological therapies have significantly improved outcomes compared to earlier experiences. Contemporary studies, including the SECA trials and the recent TransMet randomized trial, have demonstrated 5-year survival rates approaching 60%–80% in selected populations, challenging the traditional view of metastatic CRC as uniformly incurable.
The success of LT in this setting is closely linked to stringent selection criteria, including controlled primary tumor, absence of extrahepatic disease, favorable tumor biology, and response to chemotherapy. Despite encouraging survival outcomes, recurrence remains common, most frequently involving the lungs, although often with indolent behavior allowing for further therapeutic interventions.
However, the application of LT for CRLM raises important ethical considerations, particularly regarding organ allocation in the context of limited donor availability. Balancing individual patient benefit with societal resource distribution remains a key challenge.
In conclusion, LT represents a paradigm shift in the management of unresectable CRLM and offers a potential curative option in carefully selected patients. Ongoing research focusing on biomarker-driven selection and optimization of oncological strategies is expected to further refine its role within multidisciplinary cancer care.
Keywords: Cancer, Liver, Transplantation.
Citation: Topal, U. & Sarıtaş, A. G. (2026). Liver Transplantation for Colorectal Liver Metastases : Current Evidence and Future Perspectives. J Sur & Surgic Proce.,4(2):1-3. DOI : https://doi.org/10.47485/3069-8154.1030