Liver transplantation for irresectable colorectal liver metastases: still a contraindication?

Liver transplantation (LT) for irresectable colorectal cancer liver metastases (i-CRLM) has been considered up to now an absolute contraindication due to unfavorable outcomes, scarcity of grafts and ethical considerations. Recently, promising results of the Norwegian SECA trial raise the question of the utility of LT for i-CRLM with a 5-year survival rate of 60% (1). However, some concerns should be considered as to oncological selection criteria (when to perform the transplantation?) and the source of liver grafts: deceased donor at cost of recipienst listed for standard indication or living donor in a population with a higher risk of recurrence.