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Liver Cancer Treatment

Doctors at the Washington University and Barnes-Jewish Transplant Center have decades of experience treating liver cancer with liver transplantation. Our center has performed over 3,000 liver transplants, an accomplished achieved by less than 25 other centers in the nation.

Dedicated to innovative research and treatment plans, our physicians can treat patients other centers can’t, including those 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.


Early or advanced liver cancer patients who previously had little hope of survival, now have a second chance because of our expertise in liver transplantation. In addition to compassionate care, we offer:

  • Nationally recognized physicians: Barnes-Jewish Hospital is a teaching hospital staffed by more than 1,500 Washington University Physicians, the clinical practice for the Washington University School of Medicine. The academic medicine partnership has developed many treatments and procedures that are now common across the globe.
  • Advanced treatment options: Our early adoption of groundbreaking transplant techniques and approaches allow our team to manage uncommon cases that other facilities consider too complex for transplantation. Our Transplant Center is one of only a handful in the country that offers liver transplant as a treatment option for cancer of the bile duct, metastatic colon cancer, epithelioid hemangioendothelioma (a rare neuroendocrine cancer), and other types of neuroendocrine cancers.
  • Comprehensive living donation program: A living donor liver transplant means patients may receive a liver transplant sooner than expected. Learn more about living donor liver transplant.


Primary liver cancer begins in the liver. Metastatic liver cancer starts somewhere else in the body and spreads to the liver. Depending on eligibility criteria, people with certain types of early or advanced cancers in the liver may be candidates for transplant. We recognize that organ transplantation is the most innovative treatment for many diseases.

We specialize in liver transplant to treat:


Today, people with liver cancer have more treatment options than ever before. A liver transplant can be a 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 carefully evaluate each patient to determine which patients may benefit from transplantation based on whether the cancer has spread and the 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, your care team uses the latest treatments to shrink the tumor. Doing so increases the success rate of transplant surgery.

When we detect large liver tumors that don’t meet the United Network for Organ Sharing (UNOS) liver transplant criteria, we can often reduce or “downstage” the tumor size, allowing you to meet the requirements 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, including:

  • 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
  • Hepatic Arterial Infusion (HAI): Process of injecting chemotherapy directly into the liver through a robotically placed catheter

Find out more about the liver transplant process.


Hepatocellular carcinoma (HCC) is the most common type of liver cancer we treat with liver transplantation. To ensure long-term health, patients with HCC will be evaluated by transplant surgeons, hepatologists and social workers all on the same day. You may also see other medical specialists as consultants in your case, include the nephrologists and the oncology team. Our multidisciplinary team meets the day after your visit to develop a personalized treatment plan.

Patients with HCC may be candidates for liver transplants if they meet UNOS criteria.

Our team uses several strategies for more advanced cases 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 typically experience similar transplantation success rates to transplant recipients with early cancer.


Our Transplant Center is the leader in established cholangiocarcinoma treatment and transplant guidelines. If your doctor diagnoses cholangiocarcinoma before cancer has spread beyond the liver, liver transplantation may be an option to achieve a cure.

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 with small tumors whose cancer has not spread beyond the liver may be eligible for liver transplantation.


Our Transplant Center is one of only a few in the nation that performs liver transplant surgery to treat certain cases of metastatic liver cancer. 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.


Here at the Washington University and Barnes-Jewish Transplant Center, we seek all opportunities to provide our patients with a liver transplant, including those with neuroendocrine cancer. Neuroendocrine tumors are very uncommon, slow growing tumors that develop from the nerve cells and cells that produce hormones. These tumors are resistant to chemotherapy and radiation but may be treated with liver transplant.


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

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

Contact Us

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