Zanini LK, Oliveira EC, Nascimento FIM, Nacif LS. Navigating the landscape of liver transplantation in neuroendocrine tumors: A comprehensive scoping review. World J Transplant 2026; 16(2): 114278 [DOI: 10.5500/wjt.v16.i2.114278]
Corresponding Author of This Article
Lucas Souto Nacif, Chief, Researcher, Department of Liver and Gastrointestinal Transplant, Hospital 9 de Julho, Peixoto Gomide Street, 645-Cerqueira César, São Paulo 01409-002, Brazil. lucasnacif11@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
research-article
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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/
World J Transplant. Jun 18, 2026; 16(2): 114278 Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.114278
Navigating the landscape of liver transplantation in neuroendocrine tumors: A comprehensive scoping review
Leonardo Kasputis Zanini, Eduarda Costa Oliveira, Fabrício Inácio de Moraes Nascimento, Lucas Souto Nacif
Leonardo Kasputis Zanini, Department of Surgery, Federal University of São Paulo, São Paulo 04023-062, Brazil
Eduarda Costa Oliveira, Fabrício Inácio de Moraes Nascimento, Lucas Souto Nacif, Department of Liver and Gastrointestinal Transplant, Hospital 9 de Julho, São Paulo 01409-002, Brazil
Co-first authors: Leonardo Kasputis Zanini and Eduarda Costa Oliveira.
Author contributions: Zanini LK and Nacif LS contributed to conceptualization, data interpretation and they are contributed equally to this manuscript and are co-first authors; Oliveira EC, Nascimento FIM, and Nacif LS contributed to critical revision of the manuscript; Zanini LK contributed to literature review and drafting of the manuscript; Oliveira EC contributed to Data collection; Nascimento FIM contribution to the final version of the manuscript; Nacif LS contributed to supervision, and approval of the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Lucas Souto Nacif, Chief, Researcher, Department of Liver and Gastrointestinal Transplant, Hospital 9 de Julho, Peixoto Gomide Street, 645-Cerqueira César, São Paulo 01409-002, Brazil. lucasnacif11@gmail.com
Received: September 16, 2025 Revised: October 19, 2025 Accepted: February 3, 2026 Published online: June 18, 2026 Processing time: 255 Days and 11.5 Hours
Abstract
BACKGROUND
Neuroendocrine tumors (NET) are rare neoplasms with heterogeneous biological behavior. Although in these scenarios surgical resection can result in favorable outcomes, a considerable proportion of patients are not candidates for this modality due to extensive liver involvement. In these scenarios, liver transplantation (LT) may be a therapeutic alternative for these patients.
AIM
To map the main evidence for the role of LT in NET. Analyze evidence and other possible therapies.
METHODS
A review of LT for hepatic metastatic NET. MEDLINE-PubMed, Lilacs, and Cochrane Library were searched. For MEDLINE-PubMed MESH-terms used were [“Neuroendocrine Tumors” (MeSH Terms)] OR “Neuroendocrine Tumors” (All Fields)] AND [“Liver Transplantation” (MeSH Terms) OR “Liver Transplantation” (All Fields)]. Cochrane Library search: (“neuroendocrine tumors” AND “liver transplantation”). Lilacs search: (neuroendocrine tumor) AND (liver transplantation). Articles were selected based on the person-centred care framework. Two independent reviewers (Oliveira EC, Zanini LK) performed selection and quality assessment, with a third (Nacif LS) resolving disagreements.
RESULTS
After applying the inclusion and exclusion criteria based on the acronym person-centred care. A total of 73 articles out of 513 articles: 498 in MEDLINE, 12 in Cochrane, and 3 in LILACS. The last search was conducted in February 2025. No randomized controlled clinical trials or systematic reviews based on clinical trials were identified. We identified 14 reports or case series, 3 commentaries or letters to the editor, 22 retrospective cohorts, 29 narrative reviews, and 5 systematic reviews with diverse populations and based on observational studies.
CONCLUSION
LT may represent a significant benefit in overall survival for adult patients with liver metastases from NET who are not candidates for curative resection.
Core Tip: Liver transplantation is an established but uncommon treatment for patients with unresectable liver metastases from neuroendocrine tumors. This scoping review mapped the available evidence, identifying 73 studies (case series, retrospective cohorts, and reviews). Reported outcomes suggest improved overall survival in selected patients compared to non-transplant strategies, although data heterogeneity and the lack of high-level evidence limit definitive conclusions. Our findings highlight the need for prospective, multicenter studies and standardized selection criteria to optimize patient outcomes and better define the role of transplantation in this setting.
