Abstract
Neoadjuvant chemoradiotherapy followed by liver transplantation (LT) is reported as an effective treatment for patients with unresectable hilar cholangiocarcinoma, with 5-year survival is around 70%. Historically, liver transplantation alone is equally poor treatment in multiple reports. Success requires careful patient selection to exclude patients with advanced disease and regional lymph node metastasis that are destined to develop distant metastasis. Due to cadaveric donor shortage, cadaveric liver transplantation is permitted for liver cancer within Milan criteria in Japan. Therefore, living donor liver transplantation (LDLT) is required for patients with known unresectable hilar cholangiocarcinoma. Primary sclerosing cholangitis (PSC) is accompanied by an increased risk of cholangiocarcinoma. The problem is high recurrence rate of PSC is known after LDLT compared to cadaveric LT. Further discussion is needed whether indication of LDLT should be widened for patients with cholangiocarcinoma in Japan. We herein review recent reports from western countries, and summarize our data of LDLT for cholangiocarcinoma.
