Beyond futility: The history and potential of liver transplantation in cholangiocarcinoma

doi:10.5500/wjt.v15.i4.105649

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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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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

Core Tip

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.