{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:51:48Z","timestamp":1786121508437,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Transplant."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Recent ILTS guidance supports liver transplantation for patients with very small intrahepatic cholangiocarcinoma. This guidance was informed mainly by North American and European data. The applicability of these guidelines to the region of Australia and New Zealand is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was performed to measure clinical outcomes of liver transplantation in the ANZ region to ascertain the applicability of this new guidance to this region. Historic patients having undergone LT for known cholangiocarcinoma or incidentally detected cholangiocarcinoma or mixed type hepatocellular-cholangiocarcinomas on explant histology were identified via a national registry. Data was inputted from all transplant units within the ANZ region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found that 64 patients had either knowingly or unknowingly been transplanted for cholangiocarcinoma or mixed type hepatocellular-cholangiocarcinoma in our region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Overall survival for patients with very small intrahepatic cholangiocarcinomas was 80%, in line with the current international data. We also report 5-year overall survival for patients with incidentally detected mixed tumours on explant histology was 68%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frtra.2026.1856922","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:27:46Z","timestamp":1786080466000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["COMIT-ANZ: an audit of cholangiocarcinoma and mixed hepatocellular carcinoma-cholangiocarcinoma outcomes for patients undergoing liver transplantation in Australia and New Zealand"],"prefix":"10.3389","volume":"5","author":[{"given":"Georgina E.","family":"Riddiough","sequence":"first","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Austin Health Precinct","place":["Heidelberg, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kat","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Austin Health Precinct","place":["Heidelberg, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Austin Health Precinct","place":["Heidelberg, VIC, Australia"]},{"name":"ANZLITR, Austin Health","place":["Heidelberg, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Brown","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital","place":["Woolloongabba, QLD, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kilburn","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital","place":["Woolloongabba, QLD, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Kah","family":"Goh","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre","place":["Bedford Park, SA, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Marshall-Webb","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre","place":["Bedford Park, SA, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Pulitano","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital","place":["Camperdown, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Chan","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital","place":["Camperdown, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Philipoff","sequence":"additional","affiliation":[{"name":"Sir Charles Gairdner Hospital","place":["WA, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Nazaar","sequence":"additional","affiliation":[{"name":"Auckland City Hospital","place":["Grafton, Auckland, New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Austin Health Precinct","place":["Heidelberg, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"100965","DOI":"10.1016\/j.jhepr.2023.100965","article-title":"Transplant oncology\u2014current indications and strategies to advance the field","volume":"6","author":"Krendl","year":"2024","journal-title":"JHEP Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4911","DOI":"10.3390\/cancers13194911","article-title":"Transplant oncology: an evolving field in cancer care","volume":"13","author":"Abdelrahim","year":"2021","journal-title":"Cancers (Basel)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/s41586-018-0047-9","article-title":"A randomized trial of normothermic preservation in liver transplantation","volume":"557","author":"Nasralla","year":"2018","journal-title":"Nature"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2939","DOI":"10.1038\/s41467-020-16251-3","article-title":"Transplantation of discarded livers following viability testing with normothermic machine perfusion","volume":"11","author":"Mergental","year":"2020","journal-title":"Nat Commun"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1111\/ajt.16899","article-title":"Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: outcomes and risk factors for graft loss","volume":"22","author":"Hessheimer","year":"2022","journal-title":"Am J Transplant"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1111\/ajt.15241","article-title":"In situ normothermic perfusion of livers in controlled circulatory death donation may prevent ischemic cholangiopathy and improve graft survival","volume":"19","author":"Watson","year":"2019","journal-title":"Am J Transplant"},{"key":"B7","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1097\/TP.0000000000004280","article-title":"Improved organ utilization and better transplant outcomes With in situ normothermic regional perfusion in controlled donation after circulatory death","volume":"107","author":"Oniscu","year":"2023","journal-title":"Transplantation"},{"key":"B8","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1001\/jamasurg.2022.0300","article-title":"Recipient and donor outcomes after living-donor liver transplant for unresectable colorectal liver metastases","volume":"157","author":"Hernandez-Alejandro","year":"2022","journal-title":"JAMA Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jamcollsurg.2019.12.037","article-title":"Living donor liver transplantation for perihilar cholangiocarcinoma: outcomes and complications","volume":"231","author":"Tan","year":"2020","journal-title":"J Am Coll Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/j.jhep.2018.12.029","article-title":"Live donor liver transplantation for patients with hepatocellular carcinoma offers increased survival vs","volume":"70","author":"Goldaracena","year":"2019","journal-title":"deceased Donation. J Hepatol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e213112","DOI":"10.1001\/jamasurg.2021.3112","article-title":"Evaluation of the intention-to-treat benefit of living donation in patients with hepatocellular carcinoma awaiting a liver transplant","volume":"156","author":"Lai","year":"2021","journal-title":"JAMA Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.jhep.2016.10.008","article-title":"Proposal of a novel MELD exception point system for hepatocellular carcinoma based on tumor characteristics and dynamics","volume":"66","author":"Bhat","year":"2017","journal-title":"J Hepatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1053\/lv.2000.6143","article-title":"Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma","volume":"6","author":"Vreede","year":"2000","journal-title":"Liver Transplant"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2679","DOI":"10.1007\/s11605-020-04721-4","article-title":"Liver transplantation for peri-hilar cholangiocarcinoma","volume":"24","author":"Tan","year":"2020","journal-title":"J Gastrointest Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1002\/hep.28744","article-title":"Liver transplantation for \u201cvery early\u201d intrahepatic cholangiocarcinoma: international retrospective study supporting a prospective assessment","volume":"64","author":"Sapisochin","year":"2016","journal-title":"Hepatology Baltim Md"},{"key":"B16","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1111\/ajt.12591","article-title":"\u201cVery early\u201d intrahepatic cholangiocarcinoma in cirrhotic patients: should liver transplantation be reconsidered in these patients?: \u201c very early \u201c intrahepatic cholangiocarcinoma","volume":"14","author":"Sapisochin","year":"2014","journal-title":"Am J Transplant"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1097\/TP.0000000000003212","article-title":"Liver transplantation for cholangiocarcinoma and mixed hepatocellular cholangiocarcinoma: working group report from the ILTS transplant oncology consensus conference","volume":"104","author":"Sapisochin","year":"2020","journal-title":"Transplantation"},{"key":"B18","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1097\/SLA.0000000000000494","article-title":"Intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma in patients undergoing liver transplantation: a Spanish matched cohort multicenter study","volume":"259","author":"Sapisochin","year":"2014","journal-title":"Ann Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1245\/s10434-008-0278-3","article-title":"Surgical treatments and prognoses of patients with combined hepatocellular carcinoma and cholangiocarcinoma","volume":"16","author":"Kim","year":"2009","journal-title":"Ann Surg Oncol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1002\/jso.25331","article-title":"Management and outcomes among patients with mixed hepatocholangiocellular carcinoma: a population-based analysis","volume":"119","author":"Spolverato","year":"2019","journal-title":"J Surg Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1016\/j.hpb.2016.07.006","article-title":"Mixed hepatocellular and cholangiocarcinoma: a rare tumor with a mix of parent phenotypic characteristics","volume":"18","author":"Bergquist","year":"2016","journal-title":"HPB (Oxford)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1002\/jso.23289","article-title":"Transplantation versus resection for patients with combined hepatocellular carcinoma-cholangiocarcinoma","volume":"107","author":"Groeschl","year":"2013","journal-title":"J Surg Oncol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1002\/hep.25629","article-title":"Predictors of pretransplant dropout and posttransplant recurrence in patients with perihilar cholangiocarcinoma","volume":"56","author":"Murad","year":"2012","journal-title":"Hepatology"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1097\/01.tp.0000253551.43583.d1","article-title":"Predictors of disease recurrence following neoadjuvant chemoradiotherapy and liver transplantation for unresectable perihilar cholangiocarcinoma","volume":"82","author":"Heimbach","year":"2006","journal-title":"Transplantation"},{"key":"B25","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jhep.2023.03.010","article-title":"EASL-ILCA Clinical practice guidelines on the management of intrahepatic cholangiocarcinoma","volume":"79","author":"Alvaro","year":"2023","journal-title":"J Hepatol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"10802","DOI":"10.3389\/ti.2022.10802","article-title":"Outcomes after liver transplantation with incidental cholangiocarcinoma","volume":"35","author":"Safdar","year":"2022","journal-title":"Transpl Int"},{"key":"B27","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.jamcollsurg.2020.11.017","article-title":"Multi-Center analysis of liver transplantation for combined hepatocellular carcinoma-cholangiocarcinoma liver tumors","volume":"232","author":"Dageforde","year":"2021","journal-title":"J Am Coll Surg"}],"container-title":["Frontiers in Transplantation"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frtra.2026.1856922\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:27:47Z","timestamp":1786080467000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frtra.2026.1856922\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":27,"alternative-id":["10.3389\/frtra.2026.1856922"],"URL":"https:\/\/doi.org\/10.3389\/frtra.2026.1856922","relation":{},"ISSN":["2813-2440"],"issn-type":[{"value":"2813-2440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1856922"}}