Background : Curative options for patients with non-resectable colorectal liver metastases are limited, with a 5-year survival rate of less than 10%. Some groups now suggest liver transplantation as a viable alternative.

Methods : Prospective analysis of data collected retrospectively.

Results : The authors present a case series of 11 patients who underwent liver transplantation for non-resectable colorectal cancer liver metastases between 2003 and 2023. None of the patients had extra-hepatic metastatic disease. Colorectal cancer originated in the left colon in 45% (n=5) of cases, and synchronous metastases were observed in 81% (n=9), with a bilateral distribution in 54% (n=6) of cases. While 27% (n=3) of patients received a liver transplant as initial treatment, the remaining patients (n=8) underwent at least one liver resection, with 71% (n=5) of these undergoing a second liver resection before transplantation. Adjuvant chemotherapy was administered to 71% (n=5) of patients in this subgroup. The median overall survival was 86 months (SD ± 33).

Conclusions : This series comprises a heterogeneous cohort of patients, including those who met the currently accepted criteria and those for whom liver transplantation represented a last-resort treatment, resulting in variability in survival outcomes. Rigorous patient selection is essential to achieving prolonged survival in individuals with non-ressectable colorectal liver metastasis.