Liver transplants are becoming a new treatment option for certain colorectal cancer patients whose cancer has spread to their liver and who are ineligible for other surgical options. This innovative approach is providing hope to colorectal cancer patients who are often faced with a grim prognosis.

"Colorectal cancer is the fourth-most-common cancer in the United States, but it's also the second-deadliest cancer. At the time of diagnosis, about 1 in 5 patients will have metastatic disease, meaning the cancer has spread outside of the colon. The most common place we see metastasis is in the liver," says Denise Harnois, D.O., a Mayo Clinic transplant hepatologist.

In roughly a quarter of these cases, the cancer does not spread beyond the liver. Traditionally, surgeons first explore the option of cutting out the cancer in the liver. However, if the cancer has spread to more than one area of the liver, this approach may not be an option. That is when a liver transplant can be considered for patients who meet certain criteria, Dr. Harnois says.

The ideal candidate will have responded well to chemotherapy, and the colorectal cancer will not have spread beyond the liver. They are also not a candidate for surgical removal of the cancer in their liver. Patients also need to be healthy enough to undergo a liver transplant. This new approach is critical for these patients, whose five-year survival rate without a transplant is only about 15%.

"Mayo Clinic is one of very few transplant centers in the U.S. performing liver transplants on patients with colorectal cancer metastasis, in part because it's a relatively new treatment option. It also requires a multidisciplinary team of oncologists, surgeons and transplant experts who work closely together to help these patients," Dr. Harnois says.

Gary Gonzales is among those grateful this new option exists. The 59-year-old from Broomfield, Colorado, was diagnosed with colorectal cancer at age 52. The cancer soon spread to his liver. He was referred to Mayo Clinic after having undergone multiple rounds of chemotherapy and two liver resection surgeries at another institution. He had a liver transplant at Mayo Clinic in July of 2024 and says he finally feels like his old self. He is thankful for his care team and his liver donor.

"I am very grateful for that donor," Gary says. "I would definitely like to give the donor's family a hug. The donor is a part of me and my family and gave me a chance to live."