Liver transplantation for hilar cholangiocarcinoma: a German survey

Transplant Proc. 2008 Nov;40(9):3191-3. doi: 10.1016/j.transproceed.2008.08.039.


Background: The present study reports a German survey addressing outcomes in nonselected historical series of liver transplantation (OLT) for hilar cholangiocarcinoma (HL).

Patients and methods: We sent to all 25 German transplant centers performing OLT a survey that addressed (1) the number of OLTs for HL and the period during which they were performed; (2) the incidence of HL diagnosed prior to OLT/rate of incidental HL (for example, in primary sclerosing cholangitis); (3) tumor stages according to Union Internationale Centre le Cancer; (4) patient survival; and (5) tumor recurrence rate.

Results: Eighty percent of centers responded, reporting 47 patients who were transplanted for HL. Tumors were classified as pT2 (25%), pT3 (73%), or pT4 (2%). HL was diagnosed incidentally in 10% of cases. A primary diagnosis of PSC was observed in 16% of patients. Overall median survival was 35.5 months. When in-hospital mortality (n = 12) was excluded, the median survival was 45.4 months, corresponding to 3- and 5-year survival rates of 42% and 31%, versus 31% and 22% when in-hospital mortality was included. HL recurred in 34% of cases. Three- and 5-year survivals for the 15 patients transplanted since 1998 was 57% and 48%, respectively. Median survival ranged from 20 to 42 months based on the time period (P = .014).

Conclusions: The acceptable overall survival, the improved results after careful patient selection since 1998, and the encouraging outcomes from recent studies all suggest that OLT may be a potential treatment for selected cases of HL. Prospective multicenter randomized studies with strict selection criteria and multimodal treatments seem necessary.

Publication types

  • Multicenter Study

MeSH terms

  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic / surgery*
  • Cholangiocarcinoma / surgery*
  • Germany
  • Hospital Mortality
  • Humans
  • Liver Transplantation / mortality
  • Liver Transplantation / physiology*
  • Retrospective Studies
  • Survival Rate
  • Survivors
  • Time Factors