Liver Transplantation in Patients With Unresectable Colorectal Liver Metastases Treated by Chemotherapy

Inclusion Criteria: * ≥ 18 and ≤ 65 years * Good performance status, ECOG 0 or 1 (39). * Histologically proved adenocarcinoma in colon or rectum * BRAF wild-type CRC on primary tumor or liver metastases * High standard oncological surgical resection of the primary defined by : * Safe margin of resection * Curative resection of primary tumor according to oncological principles * TNM adequate staging * Absence of local recurrence on colonoscopy performed in the 12 months prior to inclusion (except in case of primary tumor resection \< 12 months ) * Confirmed non resectable colorectal liver metastases by the validation committee * ≥ 3 months of tumor control during the last chemotherapy line: Stable or Partial Response on RECIST criteria (40) * ≤ 3 lines of chemotherapy for metastatic disease * CEA \< 80 microg/L or a decrease ≥ 50% of the highest serum CEA levels observed during the disease * Absence of extrahepatic tumor localisation according to CT scan and PET-CT * Renal function should be within the normal limits * No need for extra-renal purification procedure, hemodialysis or kidney transplantation associated (nephrologist assessment) * A platelet count\> 80,000 / mm3 * White blood cell count\> 2500 / mm3 * Eligible for both treatments groups * Signed informed consent and expected cooperation of the patient for the treatment and follow up Exclusion Criteria: * Participation refusal * No health insurance facilities * General contraindication to LT (Severe cardiopulmonary disease or other life-limiting coexisting medical conditions, extrahepatic malignancy, active alcohol or substance abuse, active infection or uncontrolled sepsis, lack of psychosocial support or inability to comply with medical treatment) * Other malignancies either concomitant or within 5 years before liver transplantation * Patients not having received standard treatment for the primary CRC according to recommended guidelines * Prior extra hepatic metastatic disease or local relapse * Pregnancy at the time of inclusion