Ground-breaking Liver Transplants for Cancer Patients in Greece

In a pioneering medical milestone, Greece has performed its first successful liver transplant surgeries on patients with colorectal cancer that had metastasised exclusively to the liver. This breakthrough, achieved in June 2025 at the “Laiko” General Hospital of Athens, promises to reshape treatment possibilities for patients previously facing limited options.

Professor Giorgos Sotiro-poulos, Head of the Surgical and Transplant Clinic for Liver Disease at the National and Kapodistrian University of Athens (EKPA), led the transplant team. In June, his group performed liver transplants on two men aged 40 and 43. The younger patient was undergoing his first transplant; the other had previously undergone two partial liver resections for metastases. Both had responded well to systemic chemotherapy, exhibited no spread beyond the liver, and met rigorous international eligibility criteria. According to Professor Sotiro-poulos, both patients are currently recovering well—a development that has sparked cautious optimism for the future of this therapy in Greece.

Explainer: Why the Liver Is the First Place Colorectal Cancer Spreads

Colorectal cancer begins in the large intestine and often spreads through the portal venous system — a network of veins that drains blood from the intestines directly to the liver. This direct blood flow makes the liver the most common site for secondary tumours, known as liver metastases.

While surgery can sometimes remove these metastases, many patients have tumours in locations or numbers that make them inoperable. Until recently, chemotherapy was the only option — offering limited survival prospects. Liver transplantation for select patients is changing that equation.

Why This Matters

Globally, colorectal cancer (CRC) is among the most common cancers, and in many cases it has already spread to the liver by the time it is diagnosed. Although surgical removal of liver metastases is the best treatment where possible, only a minority—typically 20–30%—are suitable candidates. For those with unresectable liver-only disease, long-term survival and cure rates remain low using chemotherapy alone.

Recent international studies, however, are reshaping the outlook. In carefully selected patients, combining chemotherapy with liver transplantation has achieved five-year survival rates of 60–80%, compared with just 10–15% for chemotherapy alone.

Results from major studies such as Norway’s SECA-I and SECA-II trials and the multicentre TRANSMET trial in Europe have shown that for patients with colorectal cancer limited to the liver, transplantation can deliver survival outcomes previously thought impossible. For example, the TRANSMET trial reported a five-year survival rate of around 73% for transplant recipients, versus 9% for patients treated only with chemotherapy.

Selection Criteria

The impressive results rely on strict selection. Patients must have metastases confined to the liver, respond well to chemotherapy, and show no signs of disease in other organs such as the lungs. They must also have acceptable tumour marker levels and be in good overall health.

Greece Takes Its First Step

With June 2025’s successful surgeries, Greece becomes the fourth European country to adopt this protocol. The challenge now lies in ensuring adequate organ donation, multidisciplinary collaboration, and health-system readiness to offer this option to more patients.

“Liver transplantation does not promise easy answers,” said Professor Sotiro-poulos. “But it opens a new path where previously there was none. With proper support from the state and scientific community, Greece could emerge as a regional leader.”

The next steps involve strengthening cooperation between surgical, oncology, radiology, hepatology, and pathology teams, increasing organ donation rates, and refining patient selection to maximise the benefits of this life-extending treatment.

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