Affarah L, Kotha S, Berry P. Beyond futility: The history and potential of liver transplantation in cholangiocarcinoma. World J Transplant 2025; 15(4): 105649 [DOI: 10.5500/wjt.v15.i4.105649]
Corresponding Author of This Article
Sreelakshmi Kotha, Department of Hepatology, Guy's and St Thomas' Hospital, Westminster Bridge road, London SE1 7JD, United Kingdom. sreelakshmi.kotha@gstt.nhs.uk
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Gastroenterology & Hepatology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 18, 2025 (publication date) through Nov 19, 2025
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World Journal of Transplantation
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2220-3230
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Affarah L, Kotha S, Berry P. Beyond futility: The history and potential of liver transplantation in cholangiocarcinoma. World J Transplant 2025; 15(4): 105649 [DOI: 10.5500/wjt.v15.i4.105649]
World J Transplant. Dec 18, 2025; 15(4): 105649 Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.105649
Beyond futility: The history and potential of liver transplantation in cholangiocarcinoma
Lynn Affarah, Sreelakshmi Kotha, Philip Berry
Lynn Affarah, Sreelakshmi Kotha, Philip Berry, Department of Hepatology, Guy's and St Thomas' Hospital, London SE1 7JD, United Kingdom
Philip Berry, King's College London, King's Health Partners, London SE1 9RT, London, United Kingdom
Author contributions: Affarah L, Berry P and Kotha S wrote this manuscript; Kotha S and Berry P conceptualised the review. All authors have read and approved the final manuscript.
Conflict-of-interest statement: There are no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sreelakshmi Kotha, Department of Hepatology, Guy's and St Thomas' Hospital, Westminster Bridge road, London SE1 7JD, United Kingdom. sreelakshmi.kotha@gstt.nhs.uk
Received: February 2, 2025 Revised: May 12, 2025 Accepted: August 20, 2025 Published online: December 18, 2025 Processing time: 291 Days and 11.6 Hours
Abstract
Cholangiocarcinoma (CCA) is a rare type of cancer which arises from the bile duct epithelium and carries a poor prognosis. One of the main risk factors in the Western world is primary sclerosing cholangitis. Surgical resection has traditionally been the only curative treatment but can only be offered to patients with early disease, excluding those with locally advanced disease. Despite initial poor outcomes, liver transplantation (LT) has evolved as a viable treatment for a select group of patients with CCAs that are deemed unresectable. This review aims to explore the evolution of the role of LT in patients with CCA.
Core Tip: Liver transplantation (LT) had previously been contraindicated in the treatment of cholangiocarcinoma (CCA). However, recent advances in both oncological treatment and patient-selection criteria have led to a paradigm shift, with various studies showing that patients with locally advanced CCA undergoing LT have promising outcomes. Numerous centers in North America and Europe have now adopted this as standard of care. Organ scarcity is a major factor to be considered. These complex patients are best managed by a multi-disciplinary team.
