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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Sep 22, 2021; 12(5): 84-105
Published online Sep 22, 2021. doi: 10.4291/wjgp.v12.i5.84
Cholangiocarcinoma and liver transplantation: What we know so far?
Ali Reza Safarpour, Hassan Askari, Farshid Ejtehadi, Asaad Azarnezhad, Ehsan Raeis-Abdollahi, Amir Tajbakhsh, Mohammad Foad Abazari, Firoozeh Tarkesh, Alireza Shamsaeefar, Ramin Niknam, Gholam Reza Sivandzadeh, Kamran Bagheri Lankarani, Fardad Ejtehadi
Ali Reza Safarpour, Hassan Askari, Firoozeh Tarkesh, Ramin Niknam, Gholam Reza Sivandzadeh, Fardad Ejtehadi, Department of Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
Farshid Ejtehadi, The Princess Alexandra Hospital HNS Trust, Harlow, Essex CM20 1QX, United Kingdom
Asaad Azarnezhad, Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj 6617913446, Iran
Ehsan Raeis-Abdollahi, Department of Basic Medical Sciences, Qom Medical Branch, Islamic Azad University, Qom, Iran
Amir Tajbakhsh, Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
Mohammad Foad Abazari, Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran 1417653761, Iran
Alireza Shamsaeefar, Shiraz Organ Transplant Center, Shiraz University of Medical Sciences, Shiraz 7193711351, Iran
Kamran Bagheri Lankarani, Health Policy Research Centre, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
Author contributions: Safarpour AR, Azarnezhad A, Abazari MF, Ejtehadi F, Ejtehadi F, Shamsaeefar A, Niknam R, Sivandzadeh GR, and Tarkesh F collected data; Raeis-Abdollahi ER, Askari H, and Tajbakhsh A collected data and partly drafted the first version of the paper; Ejtehadi F, Safarpour AR, Askari H, and Lankarani KB designed, revised, and finalized the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fardad Ejtehadi, MD, Assistant Professor, Department of Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Khalili St, Shiraz 7134814336, Iran. edjtehadif@sums.ac.ir
Received: March 3, 2021
Peer-review started: March 3, 2021
First decision: April 19, 2021
Revised: April 28, 2021
Accepted: August 11, 2021
Article in press: August 11, 2021
Published online: September 22, 2021
Processing time: 196 Days and 9 Hours
Abstract

Cholangiocarcinoma (CCA) is a type of cancer with increasing prevalence around the world that originates from cholangiocytes, the epithelial cells of the bile duct. The tumor begins insidiously and is distinguished by high grade neoplasm, poor outcome, and high risk for recurrence. Liver transplantation has become broadly accepted as a treatment option for CCA. Liver transplantation is expected to play a crucial role as palliative and curative therapy for unresectable hilar CCA and intrahepatic CCA. The purpose of this study was to determine which cases with CCA should be subjected to liver transplantation instead of resection, although reported post-transplant recurrence rate averages approximately 20%. This review also aims to highlight the molecular current frontiers of CCA and directions of liver transplantation for CCA.

Keywords: Cholangiocarcinoma; Liver transplantation; Primary sclerosing cholangitis; Neoadjuvant chemoradiotherapy

Core Tip: Currently, there are many controversial hypotheses concerning liver transplantation in cholangiocarcinoma (CCA) and risk factors and molecular pathogenesis of CCA, with a focus on primary sclerosing cholangitis. Here, we mainly review the current advances in classification and treatment of CCA.