Liver Transplantation for Non-Resectable Colorectal Liver Metastasis

The study aims to evaluate the efficacy of liver transplantation in the context of non-resectable colorectal liver metastasis. The primary endpoint is the overall survival in this group of patients while the secondary endpoint is the disease-free survival.

Patients included in this protocol will be evaluated either for whole or partial liver transplantation from deceased or living donors.

Type of different transplantations proposed are as follows:

1. Whole liver graft or partial liver (split) from a deceased donor
2. Partial liver graft retrieved from a deceased donor and orthotopically implanted after having performed a left hepatectomy in the recipient.
3. Partial liver graft retrieved from a deceased donor and heterotopically implanted if total hepatectomy can not be performed.
4. Partial liver graft retrieved from a living donor and orthotopically implanted after having performed total hepatectomy.
5. Partial liver graft retrieved from a living donor and orthotopically implanted after having after having performed a left hepatectomy in the recipient.
6. Partial liver graft retrieved from a living donor and heterotopically implanted if total hepatectomy can not be performed.

In cases 2-3-5-6 total hepatectomy of native liver can be secondarily performed after having achieved a proper graft hypertrophy in order to avoid a small for size syndrome

Study Overview

• Status: Recruiting
• Conditions: Colorectal Cancer; Liver Metastasis Colon Cancer
• Intervention / Treatment: Procedure: Liver Transplantation

• Study Type: Interventional
• Enrollment (Anticipated): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Italy
  • Bologna, Italy, 40138
    • Recruiting
    • IRCCS Azienda Ospedaliero - Universitaria di Bologna
    • Contact: Matteo Cescon, M.D.; Phone Number: +390512144785; Email: matteo.cescon@unibo.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 71 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Primary tumor resected according to standard oncological practice, p≤T4a, R0 resection
• Colorectal liver metastasis considered as non-resectable either up-front or after previous hepatic resections
• No local recurrence of primary colon cancer confirmed by Positron Emission Tomography, Computed Tomography and colonoscopy
• No extra-hepatic metastatic disease confirmed by Positron Emission Tomography and Computed Tomography
• Good performance status Eastern Cooperative Oncology Group 0 or 1
• Neutrophils > 1.000
• Patients who received at least one line of chemotherapy for at least 3 months with partial response or stable disease according to modified Response Evaluation Criteria in Solid Tumours
• Carcino-Embryonic Antigen < 80 µg/L or reduction of ≥ 50% of highest Carcino-Embryonic Antigen level observed
• Written informed consent
• No other contraindications to liver transplantation

Exclusion Criteria:

• Presence of other malignancies
• Local recurrence of primary tumor
• Extra-hepatic metastatic disease
• Patients who did not receive any neoadjuvant or adjuvant therapy
• Palliative resection of primary tumor
• Any other reason, according to the investigators, that could be a contraindication to protocol enrollment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Liver Transplantation	Procedure: Liver Transplantation; Liver Transplantation for Non-Resectable Colorectal Liver Metastasis

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Overall Survival	5 years

Secondary Outcome Measures

Outcome Measure	Time Frame
Disease-Free Survival	5 years

Collaborators and Investigators

• Sponsor: IRCCS Azienda Ospedaliero-Universitaria di Bologna

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2021
• Primary Completion (Anticipated): March 30, 2025
• Study Completion (Anticipated): March 30, 2030

Study Registration Dates

• First Submitted: December 10, 2021
• First Submitted That Met QC Criteria: January 7, 2022
• First Posted (Actual): January 11, 2022

Study Record Updates

• Last Update Posted (Actual): January 11, 2022
• Last Update Submitted That Met QC Criteria: January 7, 2022
• Last Verified: April 1, 2021

More Information

Terms related to this study

• Keywords: liver transplantation; non-resectable colorectal liver metastasis
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Neoplasms; Neoplasms by Site; Digestive System Neoplasms; Liver Diseases; Neoplastic Processes; Neoplasm Metastasis; Liver Neoplasms
• Other Study ID Numbers: LITORALE2020

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No