Transplant Oncology Program

Overview

The Transplant Oncology Program is a specialized cancer service that brings together experts from our Adult Multi-Organ Transplant Center of Excellence and oncology specialists from our Cancer Institute. For highly selected liver cancer patients, a transplant can offer the best chance of long-term survival.

Our liver transplant specialists work closely with our surgical, medical and radiation oncology teams, as well as other supportive services, to provide liver transplantation to indicated patients through one coordinated, multidisciplinary program.

The program not only provides liver transplants for liver cancers and colorectal cancer liver metastasis, but also encompasses all critical components of transplant oncology, including techniques to remove cancers that were traditionally considered inoperable and bridging cancer research and transplant immunology. This offering is creating new ways to treat cancer and positions Cleveland Clinic Abu Dhabi’s Fatima bint Mubarak Center as a regional leader in the treatment and research in hepatobiliary cancers and long-term survivorship within a single, expert pathway.

Who We Help

There are four priority groups of liver cancer patients who may be candidates for liver transplantation:

Hepatocellular carcinoma (HCC): Patients with small/limited tumours or successfully downstaged disease. A transplant removes the cancer and the cirrhotic liver that grows new tumours.
Colorectal liver-only metastases (CLM/uCRLM): A very select group of patients with disease confined to the liver that has not spread and who have responded well to chemotherapy. A transplant can achieve long-term control/cure.
Perihilar cholangiocarcinoma (pCCA) under protocol: Early-stage patients who have completed a defined treatment pathway and restaging. A transplant offers a curative path where standard surgery isn’t possible.
Neuroendocrine liver metastases (NET/NELM): Slow-growing, low grade cancer in the liver. A transplant may offer durable survival and quality of life in selected cases.

Diagnosis & Evaluation

The diagnosis and evaluation phase focuses on strict criteria to select patients for whom a liver transplant can offer a favorable outcome. This may include:

Tumor biology assessment: Evaluation of certain tumor markers, a biopsy of the tumor and molecular profiling.
Imaging: MRI, CT or PET scans can confirm the cancer is confined to the liver.

Each patient case is then reviewed by a multidisciplinary board of transplant and oncology specialists to ensure suitability and feasibility.

Treatment

Transplant oncology offers treatment for certain liver cancers that traditionally could not be completely removed through surgery, as they are too advanced, too large to remove safely or are too close to vital organs.

Bridging and downstaging therapies

To help appropriate patients reach the liver transplant criteria, treatments such as transarterial chemoembolization, radiofrequency ablation and stereotactic body radiation therapy (SBRT) may be given. These are called bridging treatments.

Liver transplantation

A liver transplant may come from a deceased donor or a living donor. Learn more about liver transplantation here.

Post-transplant

Following a liver transplant, immunosuppressant medications will be given to manage rejection of the organ. Our program offers integrated pre- and post-operative care that balances the risk of rejection with tumor control.