UAB Opens Liver Transplant Program for Colon Cancer Patients

Patients with advanced colorectal cancer that has spread to their liver now have a chance at survival that didn't exist for them just months ago.

The University of Alabama at Birmingham launched a specialized liver transplant program in 2024 for patients whose colorectal cancer has spread to their liver and can't be surgically removed. It's one of only a handful of such programs in the Southeast.

The statistics tell a powerful story. When colorectal cancer spreads to the liver and can't be cut out, chemotherapy alone gives patients about a 10 percent chance of surviving five years. But clinical trials show that liver transplantation can raise that survival rate to between 60 and 80 percent in the right candidates.

The approach works by replacing the entire diseased liver with a donor organ, eliminating both the visible cancer and the environment that helps it grow. This represents a complete shift in how doctors view metastatic disease.

"For years, the established thinking was that metastatic disease was a contraindication for transplant. That is no longer the case," said Dr. Robert Cannon, surgical director of the UAB Liver Transplant Program. For patients with liver-only colorectal metastases who have responded to chemotherapy, transplantation becomes a real option.

The timing matters especially for young adults. Colorectal cancer is now the leading cause of cancer deaths in people ages 25 to 50, and many of these younger patients present with metastasis that could potentially be treated with liver transplantation.

The Ripple Effect

The program's impact extends beyond individual patients. UAB's living donor liver transplant program, also recently launched, allows surgeons to schedule procedures in coordination with cancer treatment rather than waiting for an organ to become available.

This means patients no longer have to endure extended waits on transplant lists that don't typically prioritize colorectal metastases cases. They also don't have to travel long distances out of the Southeast to access this lifesaving care.

The UAB Liver Transplant Program has performed over 3,000 liver transplants since 1983, with outcomes consistently ranking among the best in the nation. That experience provides a strong foundation for this new chapter in transplant oncology.

Not every patient qualifies for the program. A multidisciplinary team including transplant surgeons, hepatologists and medical oncologists reviews each patient's treatment history, imaging and chemotherapy response to determine whether transplantation is appropriate.

Dr. Sergio Acuna Mancilla, who focuses on transplant oncology, explains that response to chemotherapy and overall health all factor into the decision. The careful selection process is key to achieving the impressive survival outcomes seen in clinical trials.

The program represents how transplant oncology is changing the approach to cancers once considered beyond surgical reach, bringing cutting-edge treatment closer to home for patients across Alabama and the Southeast.