Liver transplantation for intrahepatic cholangiocarcinoma: a narrative review of the latest advances

Intrahepatic cholangiocarcinoma (iCCA) is a rare tumor that arises from second order or smaller bile ducts. Its incidence has been growing in the last couple of decades, in parallel with its mortality rates, both in America and Europe. The currently accepted gold treatment for iCCA is liver resection (LR). However, results are still poor, with 5-year survival rates ranging between 25% and 40%. In addition, more than half of the patients undergoing LR will relapse, particularly those who present with multifocal iCCA. Given the aggressiveness of this tumor, and the modest results seen with adjuvant and neoadjuvant therapies, the sights have been set on liver transplantation (LT) for this disease. Retrospective studies have shown encouraging results in select patients, especially those with very early-staged iCCA (< 2 cm) who underwent LT. The aim of this review is to analyze the current information regarding LT for iCCA, as well as future perspectives.