Liver Transplantation for Non-Resectable Intrahepatic Cholangiocarcinoma: a Prospective Exploratory Trial (TESLA Trial)

Inclusion Criteria: * Histologically verified diagnosis of Intrahepatic Cholangiocarcinoma (iCCA) * First time iCCA or liver only recurrence after previous liver resection for iCCA * Disease deemed not eligible for liver resection based on tumor location or underlying liver dysfunction * No vascular invasion, extrahepatic disease, or lymph node involvement detected on imaging * No signs of extrahepatic metastatic disease according to positron emission computed tomography (PET-CT) scan * Patient must be accepted for transplantation before progressive disease on chemotherapy. * Twelve months or more time span from the diagnosis of iCCA and date of being listed for liver transplantation * No signs of extrahepatic metastatic disease according to CT or magnetic resonance (MR) scan within 4 weeks prior to the faculty meeting at the transplant unit * At least 18 years of age * Good performance status, Eastern Cooperative Oncology Group (ECOG) 0 or 1 * Signed informed consent and expected cooperation of the patients for the treatment and follow up * Received at least 6 months of chemotherapy or locoregional therapy Exclusion Criteria: * Major vascular involvement of the tumor * Perforation of the visceral peritoneum * Weight loss \>15% the last 6 months * Patient BMI \> 30 * Other malignancies, except curatively treated more than 5 years ago without relapse * Known history of human immunodeficiency virus (HIV) infection * Prior history of solid organ or bone marrow transplantation * Substance abuse, medical, psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results * Known hypersensitivity to rapamycin * Prior extrahepatic metastatic disease * Women who are pregnant or breast feeding * Any reason why, in the opinion of the investigator, the patient should not participate