Living Donor Liver Transplantation for Unresectable Colorectal Cancer Liver Metastases

Inclusion Criteria: * Must reside in Canada * ECOG ( Eastern Cooperative Oncology Group) score : 0-1 at all times prior to LDLT (excursions to ECOG 2 allowed at investigator's discretion) * Proven colorectal Liver Metastases (LM). * Willing and able to provide written informed consent. * Negative serum pregnancy test for women of childbearing potential * Both men and women must agree to use adequate barrier birth control measures during the course of the trial. * At least 1 "acceptable", ABO-compatible living donor has stepped forward * Primary Colorectal cancer tumor stage is ≤T4a * Time from primary CRC resection to transplant is ≥6 months * Bilateral and non-resectable LM * No major vascular invasion by LM; metastases isolated to liver * The patient has undergone systemic chemotherapy (eg. FOLFOX +/- bevacizumab or FOLFIRI +/- bevacizumab) for ≥3 months * demonstrated stability or regression of LM over at minimum the 3 months preceding screening * Carcinoembryonic Antigen (CEA) values are stable or decreasing at all timepoints prior to the transplant surgery. Exclusion Criteria: * Previous or concurrent cancer (with some exceptions) * prior lung resection * Progression of LM at any timepoint prior to transplant surgery * Renal dysfunction with an estimated creatinine clearance of less than 50 ml/min * Pulmonary insufficiency * History of cardiac disease * Known history of human immunodeficiency virus (HIV) infection or chronic hepatitis B and/or C infection. * Patients …