Transplant oncology – Current indications and strategies to advance the fieldKey points
Felix J. Krendl,
Ruben Bellotti,
Gonzalo Sapisochin,
Benedikt Schaefer,
Herbert Tilg,
Stefan Scheidl,
Christian Margreiter,
Stefan Schneeberger,
Rupert Oberhuber,
Manuel Maglione
Affiliations
Felix J. Krendl
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria
Ruben Bellotti
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria
Gonzalo Sapisochin
Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada
Benedikt Schaefer
Department of Medicine I, Gastroenterology, Hepatology and Endocrinology, Medical University of Innsbruck, Austria
Herbert Tilg
Department of Medicine I, Gastroenterology, Hepatology and Endocrinology, Medical University of Innsbruck, Austria
Stefan Scheidl
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria
Christian Margreiter
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria
Stefan Schneeberger
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria
Rupert Oberhuber
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria; Corresponding authors. Address: Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; Tel.: +43 50 504 22601, fax: +43 50 504 22601.
Manuel Maglione
Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Austria; Corresponding authors. Address: Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; Tel.: +43 50 504 22601, fax: +43 50 504 22601.
Summary: Liver transplantation (LT) was originally described by Starzl as a promising strategy to treat primary malignancies of the liver. Confronted with high recurrence rates, indications drifted towards non-oncologic liver diseases with LT finally evolving from a high-risk surgery to an almost routine surgical procedure. Continuously improving outcomes following LT and evolving oncological treatment strategies have driven renewed interest in transplant oncology. This is not only reflected by constant refinements to the criteria for LT in patients with HCC, but especially by efforts to expand indications to other primary and secondary liver malignancies. With new patient-centred oncological treatments on the rise and new technologies to expand the donor pool, the field has the chance to come full circle. In this review, we focus on the concept of transplant oncology, current indications, as well as technical and ethical aspects in the context of donor organs as precious resources.
