Liver transplantation for isolated unresectable colorectal liver metastases - Protocol for a service evaluation in the United Kingdom - UKCoMET study

Menon, Krishna; Vijayashanker, Aarathi; Line, Pål-Dag; Thorburn, Douglas; Adair, Anya; Parker, Ian; Berkman, Lindy; Gelson, William; Jones, Rebecca; Manas, Derek; Middleton, Gary; Murphy, Jamie; Peddu, Praveen; Isaac, John; Perera, M Thamara P R; Prasad, Raj; Pollok, Joerg; Scarsbrook, Andrew; Zen, Yoh

doi:10.1016/j.hpb.2023.02.011

Cited by 2 publications

(4 citation statements)

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“…In addition to conventional transplant outcome measures [14] a number of CRC specific metrics will also be monitored [16]. Recorded oncological data will include the following: Overall survival, disease free survival. Disease recurrence sites and volume, and the number and type of oncological interventions posttransplant. Quality of life will also be assessed using the validated EORTC QLQ‐C30 and EORTC QLQ—LMC21 questionnaires at certain defined points, namely listing for transplantation, at each of the 6‐week restaging points while awaiting graft allocation, 6 weeks after discharge from hospital having received a transplanted liver and at 3‐monthly intervals up to the 2 year follow‐up point posttransplantation. A national registry will be instituted to record the variables outlined above and these outcome measures will be compared with those of patients who were considered for transplantation but deemed not suitable or fit enough for surgery.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Figure 1 outlines the referral pathway for patients with unresectable CRCLM who are being considered for liver transplantation. Further details regarding transplant assessment and organ allocation are outside the scope of this protocol and reported elsewhere by our group [14]; however, as patients will have to stop systemic treatment it is anticipated that transplantation will occur within a 3-month period.…”

Section: Pathway For Tr An S Pl Antati On a Ss E Ss Mentmentioning

confidence: 99%

“…While the transplant listing algorithm outlined elsewhere is designed to result in patients receiving grafts in a timely fashion it is appreciated that for most patients restaging imaging will be necessary while on the transplantation list to confirm disease stability [14]. Unless indicated for urgent clinical reasons this will occur every 6 weeks and take the form of CT chest/abdomen/pelvis, MRI of the liver with Primovist and DWI and FDG PET-CT.…”

Section: On Colog Ic Al Re a Sons Re Sulting In Delis Tingmentioning

confidence: 99%

“…In addition to conventional transplant outcome measures [14] a number of CRC specific metrics will also be monitored [16]. Recorded oncological data will include the following:…”

Section: Outcome Me a Sure Smentioning

confidence: 99%

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United Kingdom criteria for liver transplantation in the setting of isolated unresectable colorectal liver metastases

2022

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Aim: Studies have demonstrated that liver transplantation may be an effective treatment for isolated unresectable colorectal cancer liver metastases (CRCLM). Published data suggest that 5-year survival may be as high as 80%; however, recurrent disease is commonplace. Consequently, the Liver Transplantation for Unresectable Colorectal Liver Metastases Fixed Term Working Unit recommended to the NHS Blood and Transplant Liver Advisory Group that while CRCLM is an appropriate indication for transplantation, selection criteria should be conservative and that it should be undertaken within a clinical service evaluation programme. The aim of this work is to outline the proposed UK selection criteria and follow-up process for CRCLM transplantation.Method: Consensus statement by colorectal cancer/liver transplantation patient representatives, experts in colorectal cancer surgery/oncology, liver transplantation surgery, hepatology, hepatobiliary radiology, hepatobiliary pathology and nuclear medicine. Results:This study provides a comprehensive outline of the inclusion/exclusion criteria for referral in the UK. Furthermore, the referral framework is also explained. Pretransplant assessment criteria for listing/delisting are outlined. Finally, the oncology-specific outcome measures posttransplant are described. Conclusion:It is anticipated this service will begin in December 2022. A series of educational events for the referrers and transplant units will be arranged throughout 2023 to highlight CRCLM as a newly accepted UK indication for transplantation. A national audit will be undertaken to identify patients currently on treatment who meet the criteria for transplant. Data will be collected in a national registry and reviewed on an ongoing basis to confirm the safety of this treatment and to determine if the inclusion criteria require revision.

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Section: Outcome Measuresmentioning

confidence: 99%

Section: Pathway For Tr An S Pl Antati On a Ss E Ss Mentmentioning

confidence: 99%

Section: On Colog Ic Al Re a Sons Re Sulting In Delis Tingmentioning

confidence: 99%

“…In addition to conventional transplant outcome measures [14] a number of CRC specific metrics will also be monitored [16]. Recorded oncological data will include the following:…”

Section: Outcome Me a Sure Smentioning

confidence: 99%

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United Kingdom criteria for liver transplantation in the setting of isolated unresectable colorectal liver metastases

2022

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Reply to A. Jain et al

Chávez-Villa,

Ruffolo,

Byrne

et al. 2024

JCO

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We read with great interest and appreciate the pertinent commentary by Jain et al 1 regarding our manuscript. 2 We are very pleased to have an open discussion with our medical oncology colleagues, which was a key objective.The authors draw attention to the lack of emphasis regarding the inherent tumor biology when considering liver transplant (LT) for unresectable colorectal liver metastases (uCRLM). In this respect, we would like to stress that we could not agree more that disease biology cannot be ignored.

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Liver transplantation for isolated unresectable colorectal liver metastases - Protocol for a service evaluation in the United Kingdom - UKCoMET study

Cited by 2 publications

References 43 publications

United Kingdom criteria for liver transplantation in the setting of isolated unresectable colorectal liver metastases

United Kingdom criteria for liver transplantation in the setting of isolated unresectable colorectal liver metastases

Reply to A. Jain et al

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