Only a small handful of hospitals do liver transplantation to treat cholangiocarcinoma. Off the top of my head: Mayo Clinic, Barnes-Jewish, University of Michigan.
So the first question to ask:
Does Moffitt Cancer Center use LT as a treatment option for CC?
If they do, ask them whether they considered him for LT. If he is not eligible, ask them to explain why. The eligibility criteria is very strict.
If they don't, he must get a second opinion from one of the hospitals that do LT for CC.
Eligibility criteria should be fairly similar across all hospitals. For the reference, here's University of Michigan protocol and eligibility criteria:
http://www.cholangiocarcinoma.org/punbb … hp?id=4527
Here's a very good article about liver transplantation for CC:
Curing cancer by replacing livers!
http://www.ksat.com/news/Curing-cancer- … index.html
The article touches on the eligibility criteria:
What are the criteria for a patient who would be able to have the transplant?
Dr. Sonnenday: Patients for whom we think liver transplantation can be a treatment for their bile duct cancer are subjected to two different levels of selection criteria. The first is about their cancer: is the cancer confined to the liver and the bile ducts itself? We do a series of tests to make sure that there’s no evidence of cancer elsewhere including the surrounding lymph nodes. The patient can’t have an appropriate surgical resection option. The reason that we exclude patients who have a resection option even though the outcomes could at least theoretically be as good or better with transplant is that we just don’t have enough transplanted organs available for all the people already who need one. To offer liver transplantation to people who have other treatment options at this point we don’t think it’s appropriate. So, appropriate patients have to have bile duct cancer confined to the liver and bile ducts and not have a surgical resection option.
Then they have to be a transplant candidate by all the traditional criteria. They can’t have other medical conditions that would prevent them from getting the most appropriate outcomes after transplant. Patients with other cancers, or patients with advanced heart disease or lung disease -- things that would make the recovery from transplant more difficult – are not candidates for liver transplantation. Those are the same criteria that we use for any of our patients who are being considered for liver transplant.
BTW, Dr. Sonnenday posts here from time to time. If you don't get the answers at Moffitt, consider contacting Dr. Sonnenday for a second opinion about LT.