Managing Treatments

Liver Transplant: What Cancer Patients Need to Know

A liver transplant can be an effective treatment for cancer patients. Is it right for you?

In the past, having cancer would have disqualified you from receiving any kind of organ transplant. Now, advances in medicine make organ transplantation possible for cancer patients, especially for liver cancer patients. In fact, in some cases, doctors may be able to replace the cancerous liver with a healthy one.

While a liver transplant may sound like a miracle cure, there are many serious factors to consider, and not everyone is a candidate. Here’s what you need to know about liver transplantation for liver cancer patients.

How Can Liver Transplantation Help?

Liver transplants are one of the most common organ transplant surgeries. In this procedure, doctors remove the unhealthy liver and replace it with a healthy organ received from an organ donor or living donor. Since the cancerous liver is replaced, it can be an effective treatment for primary liver cancer — cancer that begins in the liver — if the cancer hasn’t spread outside of the liver.

According to the American Cancer Society, between 60 and 70 percent of people with early-stage liver cancer who receive a transplant are still alive five years after their surgery. The UVA Transplant Center specializes in this type of surgery and has performed more than 1,400 liver transplants since 1988. Overall, roughly 87 percent of adult UVA patients were alive with a healthy liver one year after their transplant, according to the Scientific Registry of Transplant Recipients.

Are You a Candidate?

When considering if you’re a candidate for liver transplantation, your cancer care team weighs several factors, such as your age, overall health and personal preference, as the American Cancer Society notes. Generally, the best candidates are those with early-stage cancer.

When evaluating patients, doctors take into account very specific criteria regarding how much of the liver is affected and the number and size of the tumor(s):

  • If you have a single tumor, it must be no larger than 5 centimeters.
  • If you have multiple tumors, there must be three or fewer tumors present, and each tumor must be 3 centimeters or smaller.

As doctors perform more transplant surgeries, some medical centers have expanded their criteria to up to 6.5 centimeters for one tumor and up to 4.5 centimeters for up to three tumors, as the World Journal of Gastroenterology reports.

Additionally, the cancer must not have spread to other parts of the body, including nearby blood vessels.

Are There Risks?

As with any major surgery, liver transplantation has risks. One of the biggest concerns is that the transplant won’t “take,” and your body will reject the new organ. You could also react to the medication required to prevent your immune system from rejecting your new liver, and you may be more susceptible to infections. Your cancer could also return.

You’re a Candidate. Now What?

It’s important to remember that there are many more people waiting for a donated liver than there are healthy livers available. So, while you may have met the criteria, it might be years before a liver becomes available for you, and not everyone will receive a donor liver.

Another option? A living donor. Since the liver regenerates, a family member or friend who matches your blood type can donate part of their liver to you. But both parties are at risk of complications with this surgery, so talk to your doctor to see if this is an option for you.

There are several other important factors to consider. Surgery can be very expensive, so if you have insurance, check your benefits. (UVA was the first Medicare-approved liver transplant center in Virginia.)

Transplant surgery and recovery can be a lengthy and overwhelming process. It helps to have a support network to lean on during this time. UVA also has programs available, and your oncology social worker can connect you to other resources and professionals who can help.

When considering liver transplantation, you may have a lot of questions. Ask your doctor and cancer care team whether transplantation is the right option for you.

If you're unsure whether a liver transplant is a viable course of treatment for you, a UVA doctor can help you understand your options.

Learn More
Christine Yu