Liver Transplantation for Incidental Cholangiocarcinoma or Combined Hepatocellular Carcinoma/Cholangiocarcinoma-Own Experiences and Review of the Literature

Simple Summary The diagnosis of intrahepatic cholangiocarcinoma in a cirrhotic liver is considered a contradiction for transplantation in Germany, as well as many other international transplantation programs. The aim of our retrospective study was to evaluate the long-term outcomes of patients with incidental combined hepatocellular- and cholangiocarcinoma and sole intrahepatic cholangiocarcinomas after liver transplantation. Between January 2010 and December 2022, iCCA was found in eight patients post-transplant. We confirmed high overall survival and low recurrence rates after liver transplantation. It can be stated that liver transplantation in the case of combined hepatocellular carcinoma and sole intrahepatic cholangiocarcinoma presents a possible curative therapy option. Background: Data about liver transplantation for mixed tumors from hepatocellular carcinoma to cholangiocarcinoma are limited. Furthermore, the diagnosis of intrahepatic cholangiocarcinoma or combined tumors in a cirrhotic liver is considered a contraindication for transplantation. Our aim was to evaluate the long-term outcomes of patients with incidental cholangiocarcinoma or combined tumors after liver transplantation. Methods: In our descriptive analysis, data were evaluated from all patients since 2010 who received a liver transplant due to an assumed hepatocellular carcinoma at Jena University Hospital. Survival rates were determined using the Kaplan-Meier method. Results: Between January 2010 and December 2022, an incidental intrahepatic cholangiocarcinoma was found in eight patients post-transplant. Four combined hepatocellular and cholangiocarcinoma and four sole intrahepatic cholangiocarcinomas were found. A recurrence through distant metastases from combined hepatocellular- and cholangiocarcinoma was found in one patient at one year after transplantation. Another patient developed a pulmonary primary tumor independently one year post-transplant. The recurrence rate was at 14.3%. While two patients died, the 1- and 5-year overall survival rates post-transplant were 87.5% and 75%, respectively. Conclusion: Patients with intrahepatic cholangiocarcinoma or combined hepatocellular- and cholangiocarcinoma could profit from liver transplantation.

Automated summary

Liver transplantation can be a possible curative therapy option for patients with combined hepatocellular carcinoma and sole intrahepatic cholangiocarcinoma. Our retrospective study found high overall survival and low recurrence rates in patients after liver transplantation for incidental intrahepatic cholangiocarcinoma or combined tumors. This suggests that liver transplantation could benefit patients with these types of liver cancer.