| dc.description.abstract | Background: Non-resectable CRLM is a common and severe manifestation of colorectal cancer associated low survival. The SECA studies on liver transplantation in unresectable disease have reported promising results with regard to survival compared to standard of care chemotherapy as well as other indications for LT. Considering the scarcity of available organs it is important to assess morbidity and mortality when introducing this treatment option into a wider clinical practice. Methods: The charts of 58 patients who received LT from 2006 to 2020 for non-resectable CRLM, as part of the prospective studies; SECA and RAPID, were reviewed for postoperative and medical complications, with emphasis on infection, graft rejection, recurrence, de novo cancer, NODAT, HT, renal dysfunction and dyslipidemia. The patients were followed from transplant until death or end of follow-up 01.10.20. Results: Median OS was 43,8 months (1,4-168,2). Twenty-one patients had NED at end of follow-up of which 9 were successfully treated for recurrence with curative intent. Twenty patients experienced acute rejection which did not significantly impact OS. 77,6% had recurrence and 7 patients developed de novo cancer. Single-site recurrence in lung or liver was associated with superior survival (p=0,023) compared to other sites or multisite recurrence. The 5-year cumulative incidence of HT, DM and hypercholesterolemia was 72,4%, 14,8% and 22,8% respectively. HT, DM and hypercholesterolemia at 1 year had no significant effect on OS, DM and hypercholesterolemia at 3 years were associated with inferior survival (p=0,002, p=0,020) while HT at 5 years was associated with increased survival (p=0,003). Timing of chemotherapy before LT did not significantly impact postoperative complications, infection or rejection. Conclusion: When analyzing postoperative and medical complications there are no obvious concerns related to safety or increased morbidity when utilizing LT as treatment in selected patients with CRLM. The incidences of postoperative and medical complications are similar to other conventional indications for LT on standard IS regimen. For the most part we did not find a link between medical complications and survival, but this could become more apparent in a long-term perspective trial, containing a larger study sample. Thus, further research within this field is needed . | eng |