Liver Transplantation for Primary and Metastatic Liver Cancer

Hope for Liver Cancer

If you have certain types of cancer in your liver, you may have been told at other hospitals that you cannot have a liver transplant. But there may still be hope.

Transplant Oncology Specialists

At the University of Chicago Medicine, we encourage you to explore all of your options, which may include a liver transplant even if you have different types of cancer in the liver that are not traditionally offered a liver transplant. There is a growing field called transplant oncology, and we are at the forefront of this growth.

At UChicago Medicine, we perform liver transplants on carefully selected patients with several types of liver cancer, including cancers that do not qualify for a transplant at other centers.

A Promising New Option: Liver Transplant Surgery for Metastatic Liver Cancer

Getting a liver on the liver transplant waitlist can be difficult for patients with certain types of cancer in the liver because they do not qualify for extra points (or exception points) from a deceased donor. The best option for such patients is often a living donor liver transplant. Because UChicago Medicine has a robust living donor liver transplant program, you may not have to wait for many months or years on a transplant waitlist if a living donor (such as a relative, friend or an anonymous donor) is able to donate a portion of their liver. Having a living donor transplant also allows you to plan your surgery so you can have the best chance for a successful outcome.

Experts at the UChicago Medicine Liver Tumor Program are considered pioneers in this type of liver transplant. Our surgical team performed the first living donor liver transplant in the United States more than three decades ago. Today, we have expanded this approach to help those with many types of advanced liver cancer.

What Types of Advanced Liver Cancer Can Be Treated with Liver Transplantation?

You may be eligible for a liver transplant at UChicago Medicine if you have:

• Primary liver cancer including:
  • Hepatocellular carcinoma (also known as HCC, the most common type representing 85% of all liver cancers)
  • Cholangiocarcinoma (bile duct cancer)
  • Select other primary cancers (including fibrolamellar cancer and hepatic epithelioid hemangioendothelioma)
• Secondary liver cancer (cancer that has spread to the liver from another organ)
  • Colorectal cancer
  • Neuroendocrine cancer

Offering these advanced treatments for patients is part of our mission. We want to help you find the best possible options to improve your quality of life and potentially live longer.

Getting Evaluated for a Liver Transplant at UChicago Medicine

Whether you reach out to us first or want to get a second opinion on your options, we are eager to help you understand what steps you can take next.

A liver transplant is a major surgery that requires significant changes to your lifestyle. That is why we make patient education a priority. At UChicago Medicine, your team of physicians and a dedicated nurse coordinator will work with you to make sure you understand what is involved and that you have adequate support before, during and after your liver transplant.

We also take great care to determine if a liver transplant is the best option for you. Our expert team will determine whether you are a candidate based on several factors. These include:

• The size of your liver tumor
• The number of tumors in your liver and elsewhere
• Your overall health
• Your ability to take care of yourself after surgery
• Other important social and psychological factors

When you come to the medical center, you will have several tests to evaluate your liver, the liver cancer and your overall health. You also will have a comprehensive evaluation with several members of our liver tumor team, including a transplant hepatologist, a transplant surgeon, an oncologist, an interventional radiologist, a radiation oncologist or an advanced therapeutic endoscopist (your providers will be assigned to you based on your type of cancer and specialists that you require). You may also request or be asked to meet with a nutritionist, psychologist or psychiatrist, and a chaplain.

If you are deemed to be a candidate for liver transplant, you will meet other members of our liver transplant team, including a nutritionist, pharmacist, social worker and your transplant nurse coordinator. Your nurse coordinator will help you navigate your treatment plan between your specialists.

We recognize that liver cancer is a complex disease that requires a coordinated plan of care, so our transplant team works in close partnership with your oncology team. Together, we will explain your treatment options and take time to answer any questions you may have.

What to Know About Liver Transplant Surgery for Liver Cancer

What is transplant oncology?

The field of transplant oncology is relatively new, especially in the United States. It involves the use of an organ transplant to treat patients with cancer, in this instance, different types of cancers in the liver.

At UChicago Medicine, our transplant oncology team is one of the most skilled in the Chicago area as well as the nation. While many hospitals do not offer liver transplants to patients with certain types of liver cancer, we aim to make this potentially life-saving treatment more widely available. Our team is involved in collaborative research with other institutions across the country and internationally.

Can cancer patients be on the liver transplant waitlist?

Patients with liver cancer can be added to the national waitlist. However, because there is a limited supply of healthy livers from deceased donors, the waitlist is often long, and patients are prioritized according to how sick they are. And depending on your type of cancer, you may not be ranked high on the list or matched with a liver.

However, a living donor transplant may be an option for you, even if you have advanced liver cancer. This type of transplant allows you to be matched with a donor outside of the deceased donor waitlist at any time.

What is a living donor transplant?

A living donor transplant can be performed when another person (a family member, friend or an anonymous donor) is willing and able to donate a portion of their own liver. In both the living donor and the recipient of the organ, the partial livers will grow and regain normal liver function.

Living donor transplants can be an option for patients with certain types of liver cancer who may not be ranked high on the liver transplant waitlist. This can help them have a higher quality of life and potentially live longer.

Living Donor Liver Transplant for Liver Cancer

At UChicago Medicine, we offer anonymous (directed and non-directed) live liver donation, which may not be available at some centers. Through this process, we match living donors to potential liver transplant candidates. This can increase your chances of finding a donor.

If you are considering this option, our team will explain what you should know about living donor liver transplantation so you understand the process.

Can I get a liver transplant if I am going through chemotherapy or radiation therapy?

Yes, this will depend on the type of cancer you have. At UChicago Medicine, we have designed specific treatment protocols for patients with liver cancer to have a liver transplant from a living donor even if they are going through different types of cancer treatment.

Can liver cancer come back after transplant?

Yes, there is always the chance that the liver cancer may return. The risks depend on the type of cancer and how aggressive it was before initial treatment. At UChicago Medicine, our team will perform a variety of tests, including genomic analysis of your tumor, to determine your risks.

Other risks of having a liver transplant include:

• Organ rejection
• Bleeding
• Infection
• Complications from anesthesia

When you come to UChicago Medicine, our liver transplant team will take the time to explain the risks and benefits of having a liver transplant for advanced liver cancer. They also will answer your questions so you can make the most informed decision about your care.

What other new liver cancer treatments are available or in development?

New treatments for advanced liver cancer available at UChicago Medicine include immunotherapy and targeted drug therapies, as well as new approaches to chemotherapy and radiation therapy. We also offer different types of locoregional therapy including transarterial chemoembolization, transarterial radioembolization, radiofrequency ablation/microwave ablation and stereotactic body radiation therapy (SBRT) for advanced liver cancer. These treatments target tumors directly to preserve as much healthy liver tissue as possible.

Promising research on new treatments for liver cancer is currently underway at UChicago Medicine. Through these clinical trials, we can provide new immunotherapies and a combination of the latest chemotherapies for advanced liver cancer. Many of these treatment options are not widely available elsewhere.

Why should I see the doctors at UChicago Medicine to treat my advanced liver cancer?

Using innovative approaches like liver transplants to treat advanced liver cancer is why patients from all over Illinois and across the country come to our cancer and digestive disease programs, which are ranked among the best in the nation by U.S News & World Report.

Physicians at the UChicago Medicine Liver Tumor Program have a long history of providing innovative care to liver patients. More than 30 years ago, our surgeons performed the first living donor liver transplant.

Meet Our Team of Specialists

And because we are designated as a Comprehensive Cancer Center by the National Cancer Institute, we can offer you the latest scientific advances for treating cancer that are not widely available elsewhere.

We believe that our team-based approach to care provides more safe and effective treatment options for advanced liver cancer. Even if you were told that a transplant would never be possible for you, we may be able to help. Please contact us at 1-855-702-8222.