LIver Transplantation for Non-Resectable Intrahepatic CholAngiocarcinoma (LIRICA)

Inclusion Criteria: * Histologically confirmed diagnosis of iCCA * First diagnosis of iCCA * Recurrence after R0 hepatic resection, N0, M0 without macrovascular invasion * Disease considered unsuitable for hepatic resection based on tumor location and extent or underlying liver dysfunction * Absence of major vascular invasion, extrahepatic disease, or involvement of regional lymph nodes detected on radiological study * No evidence of extrahepatic metastatic disease after chest-abdomen-pelvis CT and PET-MR (or PET-CT) * At least six months have passed since the first diagnosis of iCCA (or recurrence) to the date of inclusion on the liver transplant waiting list * The patient has received at least six months of SOC chemotherapy, achieving disease stability or partial response (according to RECIST version 1.1) at the time of listing for transplantation * Hematochemical evaluation: Hb ≥ 9 g/dL, Leukocytes ≥ 3.0 X 109/L, Neutrophils ≥ 1.5 X 109/L, Platelets ≥ 100,000/mm3 (≥ 10 X 109/L), Total Bilirubin ≤ 3 mg/dL (≤ 51 umol/L), AST or ALT ≤ 5 times the upper limit of normal, Serum Creatinine and Urea \< 1.5 times the upper limit of normal * ECOG (Eastern Cooperative Oncology Group) performance status ≤ 1 * Patient's BMI ≥ 18 and ≤ 30 kg/m2 * Signed informed consent, and expected patient cooperation for treatment and follow-up, must be obtained and documented according to good clinical practice and national/local regulations Exclusion Criteria: * Tumor involving nearby extrahepatic structures (including involvement of major hepatic vessels) by direct invasion (T4 per AJCC 8th edition) * Tumor penetrating the visceral peritoneum (T3 per AJCC 8th edition) * Previous extrahepatic metastatic disease * Prior neoplasms, except those treated curatively for more than 5 years without recurrence * Known history of human immunodeficiency virus (HIV) infection * Known history of solid organ or bone marrow transplantation * Substance abuse and medical, psychological, or social conditions that may interfere with the patient's participation in the study or with the evaluation of study outcomes * Pregnant or breastfeeding women * Medical-surgical contraindications for liver transplantation * Any reason for which, in the investigator's judgment, the patient should not participate in the study