Perihilar cholangiocarcinoma (pCCA) is a highly lethal hepatobiliary malignancy. Its location at the hepatic duct confluence frequently causes biliary and vascular involvement, often precluding complete resection. Even in high-volume centers, fewer than one-third of patients are resectable and long-term survival rarely exceeds 40%. Liver transplantation (LT) has emerged as a potential option after the outstanding results of the Mayo Clinic protocol (MCP). However, several limitations have hin- dered its widespread adoption.2 This article examines these limitations and proposes a nationally standardized Italian pathway for LT after standard-of-care (SOC) systemic therapy (ST), to be prospectively evaluated in the LITALHICA (LIver TrAnspLantation for nonresectable peri-hilar cholangioCArcinoma) trial.
From Clinical Heterogeneity to National Standardization in Liver Transplantation for Perihilar Cholangiocarcinoma: The LITALHICA Protocol
Tandoi, FrancescoMembro del Collaboration Group
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2026-01-01
Abstract
Perihilar cholangiocarcinoma (pCCA) is a highly lethal hepatobiliary malignancy. Its location at the hepatic duct confluence frequently causes biliary and vascular involvement, often precluding complete resection. Even in high-volume centers, fewer than one-third of patients are resectable and long-term survival rarely exceeds 40%. Liver transplantation (LT) has emerged as a potential option after the outstanding results of the Mayo Clinic protocol (MCP). However, several limitations have hin- dered its widespread adoption.2 This article examines these limitations and proposes a nationally standardized Italian pathway for LT after standard-of-care (SOC) systemic therapy (ST), to be prospectively evaluated in the LITALHICA (LIver TrAnspLantation for nonresectable peri-hilar cholangioCArcinoma) trial.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
