Liver Transplantation for Unresectable Liver Limited Colorectal Metastases

Inclusion Criteria: 1. Histologically confirmed adenocarcinoma of the colon or rectum 2. No evidence of extrahepatic metastases or local recurrence based on PET/CT and colonoscopy 3. No signs of extrahepatic metastases or local recurrence according to PET/CT 4 weeks prior to consideration of transplant 4. Age 18-65 years old 5. Good performance status with ECOG 0-1 6. Stability or regression of liver metastasis for at least 6 months 7. Minimum of 1 year between diagnosis of colon cancer and liver transplant and 6 months from primary tumor resection and liver transplant 8. Minimum of 6 months chemotherapy 9. CEA \< 200 ug/L 3 months prior to transplant 10. Adequate organ and marrow function with Hb \> 10 g/dL, ANC \> 1000/uL, platelets \> 100,000/uL, bilirubin \< 2x ULN, AST/ALT \< 5x ULN, Creatinine \< 1.25 x ULN, Albumin above LLN Exclusion Criteria: 1. Evidence of extrahepatic disease or local recurrence 2. Previous resection of lung metastases 3. MSI-H/dMMR or BRAF mutation 4. Any other medical or co-morbid condition that would preclude liver transplantation, as determined by the transplant team