In Germany, the incidence of primary liver cancer and liver metastases is steadily increasing-especially for hepatobiliary malignancies. Primary liver malignancies include hepatocellular carcinoma (HCC), cholangiocarcinoma (CCC) and the rare hepatocellular-cholangiocarcinoma (mixed tumor). Depending on tumor entity and the underlying liver disease, indication and long-term results for liver transplantation differ significantly. In highly selected patients with hepatic metastases of gastrointestinal neuroendocrine tumors (NET) or nonresectable colorectal liver metastases (i-CRLM), liver transplantation can be acurative treatment option. Due to the very low number of organ donations especially in Germany, the indication and selection of patients for liver transplantation has to follow the principles of urgency, prospect of success, and equal opportunity. The aim of this review article is to provide an overview of transplant indications and organ allocation rules as well as give insight into recent international developments regarding new prognostic models and new indication criteria for liver transplantation in patients with hepatic malignancies or liver metastases who cannot be otherwise curatively treated.
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