*Purpose: Colorectal cancer (CRC) is the third most common cancer worldwide. About 50% of patients with CRC will develop metastases during the course of the disease, with the liver being the most organ involved. There are many treatment options for resectable Colorectal Liver metastasis (CLM)whereas unresectable colorectal liver metastasis is treated with palliative chemotherapy. Liver transplantation (LT) is a treatment option but still controversy

*Methods: We report a case of 37-year old male who was diagnosed with colon cancer in 2015 andunderwent resection of the primary cancer in January 2016. CT CAP was done back then which showed 3 liver lesions with elevated CEA of 8. So the patient was offered adjuvant chemotherapy and the case was referred to our hospital for possible further management.Patient was fully reevaluated in our hospital, where CT CAP & MRI Liver were done. Liver MRI showed 2 lesions in segment 7 & 6.There was another suspicious small lesion in segment 4A as well.So, he underwent Right hepatectomy, where more than 50 % of liver volume was preserved. The quality of the remnant liver was grossly marginal. The patient developed acute liver failure post resection.Given the fact that this patient is young, we decided to go ahead with salvage liver transplantation. With 26 month of follow up, the patient has no signs of recurrence

*Results: SECA Study (SEcondary CAncer) aimed to assess the survival and quality of life in patients undergoing liver transplantation for unresectable CLM showed a 5-year overall survival of 60%, with a better quality of life. Moreover, Toso et al, published a retrospective study that showed the 1-year and 5-year survival in patients with unresectable CLM who underwent liver transplantation to be 83 and 50%., respectively. Dueland et al. compared the result of patients with CLM who underwent liver transplantation and those who underwent liver transplantation due to HCC. They observed that despite higher tumor load in selected number of patients with colorectal metastases, the 5-year survival rate was better than or similar to patients with HCC. It also has been shown that immunosuppression therapy for patients with colorectal liver metastases didn’t influence the course of the metastatic disease in these patients. Three trials are currently underway, including SECA II in which they are utilizing stricter inclusion criteria and will also assesses the outcome of liver transplantation of resectable CLM comparing with resection

*Conclusions: Our case emphasize that liver transplantation could be an option for some patients, offering them better survival rate and quality of life. Thus, more research is needed to identify selection criteria for patients who may benefit from liver transplantation particularly in countries where there is organ donor’s shortage

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