Abstract
Background/Objectives: Intrahepatic cholangiocarcinoma (ICC) and combined hepatocellular-cholangiocarcinoma (CHC) have historically been considered a contraindication for liver transplantation (LT) due to poor prognosis. However, incidental ICC/CHC has been reported in small amounts of patients undergoing LT. Methods: A retrospective cohort study was conducted to analyze patients undergoing LT with incidental ICC/CHC at our center between January 2010 and December 2021. Results: 28 patients including 12 incidental ICCs and 16 CHCs on explant were identified. Median follow-up after LT was 63 months and 13 patients died due to tumor recurrence. The 1-, 3-, and 5-year survival rates for the whole group were 85.7%, 64.3%, and 53.3%, respectively. There was no significant difference in survival rates between the ICC and CHC groups. RFS and OS in the group with tumors less than 3 cm at 1, 3, and 5 years were 85.7%, 78.6%, and 70.7% and 92.9%, 78.6%, and 64.3%, respectively, which were significantly higher than those with tumors over 3 cm (p = 0.029 and 0.089, respectively). Additionally, patients within the Milan criteria also had a superior RFS (p = 0.032) and OS trend (p = 0.097) when compared with those beyond the Milan criteria. Conclusions: These results suggest that LT could be an option for highly selected patients with an early stage of ICC/CHC.