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Chinese Journal of Transplantation(Electronic Edition) ›› 2025, Vol. 19 ›› Issue (06): 470-474. doi: 10.3877/cma.j.issn.1674-3903.2025.06.015

• Review • Previous Articles    

Advances in liver transplantation for nonresectable colorectal liver metastases

Jincai Jiang1, Jianhong Hao2, Yufu Ye1,()   

  1. 1Department of Hepatobiliary and Pancreatic Surgery Liver Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China
    2Department of Hepatobiliary and Pancreatic Surgery, Haining Campus, the First Affiliated Hospital, Zhejiang University School of Medicine, Jiaxing 314400, China
  • Received:2025-08-08 Online:2025-12-25 Published:2026-04-03
  • Contact: Yufu Ye

Abstract:

Colorectal cancer is among the most common malignancies worldwide, and nearly half of patients will develop colorectal liver metastases (CRLM). Over the past three decades, systemic therapy and hepatic resection have remained the cornerstone treatment strategies for CRLM. However, only about 20% of cases are amenable to curative-intent resection. The prognosis of nonresectable colorectal liver metastases (nrCRLM) is dismal, with 5-year overall survival approaching zero. In the 1980s, surgeons attempted to extend liver transplantation to patients with nrCRLM, but this approach was largely abandoned because of high perioperative mortality and frequent post-transplant recurrence. With continued advances in systemic therapy and transplant techniques, accumulating evidence indicates that, in carefully selected patients with nrCRLM, liver transplantation can achieve 5-year overall survival of up to 60%, suggesting a potential long-term survival benefit in selected populations and positioning transplantation as a potentially curative option for a subset of patients. This review summarizes recent progress in liver transplantation for nrCRLM, focusing on its historical development, prognostic factors, recipient selection criteria and key challenges related to organ scarcity and allocation policies.

Key words: Liver transplantation, Colorectal cancer, Nonnresectable, Liver metastases, Shortage of donor liver

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