A multicentre, open-label, prospective, randomized controlled trial (TransMet) assessed liver transplantation plus chemotherapy in 94 patients (intention-to-treat population) with permanently unresectable colorectal liver metastases from resected BRAF-non-mutated colorectal cancer and with no extrahepatic disease. The trial took place in 20 tertiary centres in Europe between 2016 and 2021.

Patients were randomly assigned (1:1) to the liver transplantation group plus chemotherapy (group A) or chemotherapy alone (group B). Overall, 74 patients were included in the per-protocol analysis. In the intention-to-treat population, 5-year overall survival was 56.6% for group A and 12.6% for group B (HR 0.37; 95% CI 0.21–0.65; P = 0.0003), whereas in the per-protocol analysis population, it was 73.3% and 9.3%, respectively (HR 0.36; 95% CI 0.07–0.33; P = 0.0001).