Liver Transplantation for Unresectable Intrahepatic Colangiocarcinoma After Sustained Response to Neoadjuvant Treatments

Who May Qualify: - Histological diagnosis of iCCA (biopsy-proven tumor) - Either first diagnosis or post-resection recurrence (occurring ≥ 6 months after resection) - Unresectability assessment due to tumor location (leading to insufficient live remnant with/out implementation of hypertrophic parenchymal techniques) or underlying liver disease. Non-resectability assessed by an expert surgical team with experience on both resection and transplantation (centralized at INT Milan). - Age between 18 and 70 years - No macrovascular tumor invasion (NB: portal vein and/or hepatic vein occlusion from the external tumor compression and classified as "encasement" could be considered after expert radiology review) - No extrahepatic spread - Disease stability for at least 6 months - CA 19-9 \< 200 u/ml at transplant listing in absence of jaundice - No medical and surgical contraindications to liver transplantation - Good performance status, Eastern Cooperative Oncology Group (ECOG) 0 or 1 - No concomitant malignancies or history of other malignancies in the previous 5 years - Written willing to sign a consent form Who Should NOT Join This Trial: - Hilar and distal cholangiocarcinoma - Progression of disease under chemotherapy +/- radiation therapy, assessed with either RECIST, mRECIST or Choi criteria - Evidence of lymph-nodal metastases - Evidence of extrahepatic disease - Prior extrahepatic metastatic disease - Concomitant malignancies or history of other malignancies in the previous 5 years - Substance abuse, medical, psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results - Any reason why, in the opinion of the investigator, the patient should not participate to the study Always talk to your doctor about whether this trial is right for you.