Transplantation for the Management of Malignancy

This chapter describes the diagnostic approach, determination of candidacy, and the process to liver transplantation for patients with hepatocellular and cholangiocarcinoma. Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, which usually occurs in the presence of cirrhosis. Cholangiocarcinoma is a cancer of the epithelial cells (cholangiocytes), which line the bile ducts of the liver. It is the second most primary liver cancer after HCC. The chapter discusses briefly transplantation for metastatic neuroendocrine tumor (NET) and hepatic epithelioid hemangioendotheliomatosis. Pancreatic and small intestinal NET arise from cells of the neuroendocrine system. These patients often present with extensive metastatic disease to the liver. Liver transplantation is a viable option to provide long-term benefits to patients with metastatic NET, but in the context of the scarcity of organ availability, patients need to undergo a thorough and stringent pre-transplantation evaluation to confirm their candidacy.