{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:39:26Z","timestamp":1785425966149,"version":"3.56.0"},"reference-count":50,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"publisher","award":["2020067"],"award-info":[{"award-number":["2020067"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"publisher","award":["2026079"],"award-info":[{"award-number":["2026079"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2020067"],"award-info":[{"award-number":["2020067"]}],"id":[{"id":"https:\/\/ror.org\/02qx2s478","id-type":"ROR","asserted-by":"publisher"}]},{"award":["2026079"],"award-info":[{"award-number":["2026079"]}],"id":[{"id":"https:\/\/ror.org\/02qx2s478","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Liver transplantation (LT) has re-emerged as a potentially curative treatment for carefully selected patients with unresectable, liver-only colorectal liver metastases (CRLM). Prospective trials (SECA-I\/II) demonstrated 5-year overall survival (OS) rates of 60\u201383% in selected patients, findings recently corroborated by the randomized TransMet trial, which showed superior 5-year OS with LT compared with chemotherapy alone. Favorable outcomes depend on rigorous patient selection integrating clinical risk stratification (Oslo Score), tumor burden assessed by metabolic tumor volume on FDG-PET-CT, and molecular profiling, while excluding high-risk features such as BRAF V600E and RAS\/TP53 co-mutations. Broader implementation raises ethical challenges related to organ allocation, driving interest in alternative strategies including living-donor LT and innovative procedures such as RAPID. This narrative review summarizes evolving evidence supporting LT for CRLM, current approaches to patient selection, oncological outcomes, and practical considerations for implementing LT into contemporary HPB and transplant practice.<\/jats:p>","DOI":"10.3390\/cancers18142306","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:00:52Z","timestamp":1784278852000},"page":"2306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liver Transplantation for Unresectable Colorectal Liver Metastases: Evidence, Patient Selection, and Clinical Implementation"],"prefix":"10.3390","volume":"18","author":[{"given":"Tor Magnus","family":"Smedman","sequence":"first","affiliation":[{"name":"Transplant Oncology Research Group, Division of Surgery and Specialized Medicine, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Department of Oncology, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5smund Avdem","family":"Fretland","sequence":"additional","affiliation":[{"name":"Department of HBP Surgery, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"The Intervention Centre, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svein","family":"Dueland","sequence":"additional","affiliation":[{"name":"Transplant Oncology Research Group, Division of Surgery and Specialized Medicine, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Solheim","sequence":"additional","affiliation":[{"name":"Transplant Oncology Research Group, Division of Surgery and Specialized Medicine, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Department of Transplantation Medicine, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Hagness","sequence":"additional","affiliation":[{"name":"Transplant Oncology Research Group, Division of Surgery and Specialized Medicine, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Department of Transplantation Medicine, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer","family":"Lassen","sequence":"additional","affiliation":[{"name":"Department of HBP Surgery, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Department of Clinical Medicine, UiT the Arctic University of Norway, 9037 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5884-9336","authenticated-orcid":false,"given":"P\u00e5l Dag","family":"Line","sequence":"additional","affiliation":[{"name":"Transplant Oncology Research Group, Division of Surgery and Specialized Medicine, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Department of Transplantation Medicine, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5696-2319","authenticated-orcid":false,"given":"Sheraz","family":"Yaqub","sequence":"additional","affiliation":[{"name":"Department of HBP Surgery, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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