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Liver Cancer Transplant Options

Doctors at the Washington University and Barnes-Jewish Transplant Center have decades of experience treating liver cancer with liver transplant. We are one of few centers in the country who offer liver transplant as a treatment option for patients with certain types of liver cancer. 

We can treat patients other centers can’t, including those with larger tumors and more advanced liver cancers. Our transplant team works closely with the experts at Siteman Cancer Center to determine the best treatment options for your needs.

Liver Cancer and Transplantation: Why Choose Barnes-Jewish?

Patients from across the nation seek us out because of our specialized expertise treating early and advanced liver cancers. We offer: 

  • Depth of experience: Our team has performed more than 2,000 liver transplant surgeries. We are national leaders in highly specialized areas of organ transplant.
  • Care for complex cases: Our specialized expertise allows our team to successfully manage advanced cases other centers considered too complex for transplantation. We are the only center in the region that provides liver transplants for eligible patients with certain liver and bile duct cancers.
  • Innovative transplant options: Our Transplant Center is one of just a handful in the country that offers liver transplant as a treatment option for some patients with epithelioid hemangioendothelioma (a rare neuroendocrine cancer) and select cases of metastatic colon cancer. 
  • Comprehensive living liver donation program: A living donor liver transplant means some patients may receive a liver transplant much sooner than they otherwise would. Learn more about living donor liver transplant.

Liver Cancers We Treat With Liver Transplant

Primary liver cancer is cancer that begins in the liver. Metastatic liver cancer is cancer that starts elsewhere in the body and spreads to the liver. People who have certain types of early or advanced cancers in the liver may be candidates for transplant, depending on specific eligibility criteria. 

We specialize in liver transplant to treat:

How We Treat Liver Cancer With Transplantation

Today, people with liver cancer have more treatment options than ever before. A liver transplant can be a potentially curative treatment for liver cancer. Transplantation removes the whole liver, replacing it with a new, healthy liver from a deceased or living donor. 

Our specialists determine which patients may benefit from transplantation based on several factors, such as whether the cancer has spread and tumor size. If you have liver cancer, the average wait time for a deceased donor liver is 9-12 months. While you are waiting for a liver, our specialists use the latest treatments to shrink the tumor. Shrinking the tumor increases the success rate of transplant surgery.

When we detect large liver tumors that don’t meet United Network for Organ Sharing (UNOS) liver transplant criteria, we can often reduce or “downstage” tumor size so you meet the criteria for a liver transplant. Your doctor may recommend chemotherapy, radiation therapy or advanced interventional radiology treatments as alternatives to or in combination with liver transplantation:

  • Surgery: Liver resection, or surgical removal of the cancer
  • Chemo-embolization: Injection of drugs directly into the tumor to kill cancer cells and cut off the tumor’s blood supply
  • Radio-embolization: Injection of radioactive microscopic glass spheres into the tumor
  • Radiofrequency (RF) ablation: Placing a probe into the tumor and using radio waves to kill cancer cells and shrink the tumor. Find out more about radiofrequency ablation.
  • External beam radiation: Radiation beams targeted directly at the tumor

Find out more about the liver transplant process.

Liver transplant for hepatocellular carcinoma (HCC)

HCC is the most common type of liver cancer we treat with liver transplantation. Patients with HCC can see multiple specialists on the same day. Our team meets the day after your visit to develop a personalized treatment plan. 

Patients with HCC may be a candidate for liver transplant if they meet UNOS criteria for liver transplant due to HCC. 

For more advanced cases, our team uses several strategies to help shrink tumors. We then reevaluate each case to determine if transplant is the best option. Patients for whom these alternative treatments are effective often experience similar transplantation success rates to transplant recipients with early cancer.

Liver transplant for cholangiocarcinoma (bile duct cancer) 

Our Transplant Center is one of just a handful in the country with established cholangiocarcinoma treatment and transplant guidelines. If your doctor diagnoses cholangiocarcinoma before the cancer has spread beyond the liver, liver transplantation may be an option. Once a patient receives a liver transplant, the chance of cancer coming back in the liver is very low.

Our specialists perform transplant surgery to treat two types of bile duct cancer:

  • Hilar cholangiocarcinoma: This cancer, also called Klatskin tumors, develops where the bile ducts divide in the liver (the right and left hepatic ducts). Patients who show no evidence of disease outside the liver after chemotherapy and radiation therapy may be eligible for liver transplantation. Patients who live far away can often get chemotherapy closer to home before their liver transplant surgery.
  • Intrahepatic bile duct cancers: This cancer develops in the small bile duct branches in the liver. Patients who have small tumors and whose cancer has not spread beyond the liver may be eligible for liver transplantation.

Liver transplant for epithelioid hemangioendothelioma (EHE)

Less than two dozen cases of EHE are diagnosed each year. This rare cancer can affect any area of the body, commonly showing up in the liver, lungs or bone tissue. 

Our transplant team has specialized expertise in performing liver transplant surgery to treat EHE. If your doctor diagnoses EHE before the cancer has spread beyond the liver, liver transplantation may be an option. Your doctor may recommend transplantation in combination with other advanced therapies, such as radioembolization or surgery, to effectively treat the cancer. 

Liver transplant for metastatic colon cancer

Our Transplant Center is one of only a few in the country that performs liver transplant surgery to treat select cases of metastatic liver cancer once patients have exhausted other treatment options. When patients have only limited cancer cells remaining in the liver (and no cancer elsewhere in the body), we may consider liver transplantation as a potentially curative treatment. 

Contact Us

For more information about the liver transplant program at the Washington University and Barnes-Jewish Transplant Center, call 888.202.6908.