Insights on liver transplantation and multimodal treatment for intrahepatic cholangiocarcinoma

The treatment of intrahepatic cholangiocarcinoma (iCCA) has traditionally been limited to surgical resection or systemic therapy. The role of liver transplantation in the management of iCCA is a topic currently being explored. This paper serves as a review to highlight past, present, and future work being done in regard to liver transplantation for iCCA. Strict protocols with specific selection criteria have shown promising results. Neoadjuvant therapy, locoregional therapy, and immunotherapy are some of the tools that may aid in bridging selected patients with iCCA to liver transplantation. There are currently three ongoing trials designed to further evaluate the efficacy of liver transplantation for iCCA. As criteria continue to be refined and evidence accumulates, liver transplantation may become a suitable option as a curative treatment strategy for highly selected patients with unresectable intraoperative cholangiocarcinoma.