Liver Transplantation for Colorectal Cancer

Inclusion Criteria: * Adult patients aged 18 years or older at the time of evaluation for liver transplantation. * Both male and female patients are eligible; there are no restrictions based on sex or gender. * Patients with colorectal cancer (CRC) for whom liver transplantation has been approved as a potential treatment by the institutional liver transplant committee. * Histologically confirmed adenocarcinoma of the colon or rectum. * Patient not eligible for curative liver resection. * Resection of the primary tumor ≥6 months before the planned date of transplantation. * Standard surgical procedure with adequate resection margins, including a circumferential resection margin (CRM) of ≥2 mm for patients with rectal cancer. * No signs of local recurrence on colonoscopy. * Radiological and biomarker (CEA) response to treatment after at least 6 months of systemic therapy. For some higher-risk patients, the multidisciplinary tumor board may require 12 months of response. * ECOG performance status 0-1. * No signs or history of extrahepatic metastases on chest/abdomen/pelvis computed tomography (CAP CT) or magnetic resonance imaging (MRI), and on whole-body positron emission tomography/computed tomography (PET/CT). * Carcinoembryonic antigen (CEA) level below 80 ng/mL at the time of listing for liver transplantation. * BRAF wild-type and microsatellite stable (MSS). * Deemed an appropriate transplant candidate by the liver transplant candidate evaluation committee and in accordance with transplant selection criteria. * A potential living donor available and eligible under Chilean living-donor transplantation law. Exclusion Criteria: * Evidence or history of extrahepatic metastases on CT (chest/abdomen/pelvis), MRI, or whole-body PET/CT * BRAF-mutated tumor * Microsatellite instability-high (MSI-H) tumor