Living Donor Liver Transplantation for Imatinib‐Resistant Gastrointestinal Stromal Tumor Liver Metastases: A New Therapeutic Option in Transplant Oncology

BACKGROUND Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Surgery is the cornerstone of its treatment, although during the last ten years the administration of tyrosine kinase inhibitors (TKI) has become an essential tool as a neoadjuvant and adjuvant strategy in non-wild type GIST. Previous experience has shown that when liver resection is not feasible, liver transplantation (LT) can be considered, although it has not been considered a standard indication for cadaveric LT listing. CLINICAL CASE We report a case of massive gastric-origin wild-type GIST metastatic liver disease in a young woman, with no response to adjuvant TKI therapy after partial gastrectomy, developing an indolent liver-confined disease with chronic intractable pain and malnutrition. A living donor LT was performed, with no recurrence detected after 41 months of follow-up. CONCLUSION This report suggests a new oncological LT indication for wild-type metastatic GIST confined to the liver. To the best of our knowledge, this is the first case of liver metastatic GIST treated with living donor LT.