Review for 10.1186/s12876-021-01778-6 (2021)

Reviewer’s report
Title: 
Salvage Liver Transplantation After Resection of Colorectal Cancer Liver
Metastasis With Favorable Outcomes; A Case Report And Review of literature
Version: 
1 
Date: 
15 Feb 2021
Reviewer's report:
I appreciate the editing of the manuscript by the Authors.
Still some points remain unclear. 
In Abstract: 
- "who underwent resection of left colon cancer and was found to have liver
metastasis" does not clarify whether he had synchronous or metachronous
disease. Please state which one of the two.
- "We reviewed the literature and some of these studies in this article and
compared their outcomes". The sentence sounds awkward and should be
rephrased. In addition, it'd be useful to briefly mention what is the state of the
literature in regards of salvage LT after POLF in patients resected for CRLMs,
otherwise it's pointless to say so in the abstract.
In main text: further refinements in English language editing are still necessary.
E.g.: 
- in main text, background: "treated in generally" should be "generally (or more
commonly) treated"; 
- in case presentation: " CT chest abdomen pelvic" should be "pelvis"; 
- "was done back then" is very informal and should be rephrased;
These are only a few examples while the whole manuscript needs further
changes.
The sequence of events should be better detailed: the patient presented with
synchronous disease, for what I understand: please specify why he had colon
resection instead of chemotherapy first, as it is more often the case nowadays in
synchronous disease. Authors can also emphasize that the first part of the
patient's management happened in a different center. Please also explain the
reason for the stoma in a chemorad-naive left hemicolectomy. 
The Authors state that there were three lesions, one of which iwas in seg4a
(which obviously falls within the left hemiliver), therefore the operation must
have comprised a deviation inside the left hemiliver to have that met excised.
Please detail the operation to explain how this lesion was treated. 
To persuade the readers about the decision to perform a right hepatectomy, some
more iconography should be presented, as I suggested in my previous review.
Reconsider the following sentence: "To decrease the risk of having positive
margin in the right portal vein preserved and with the fact that the preoperative
liver function tests were completely normal, and the future liver remanent
volume by CT volumetry was more than 50%, a decision was made to proceed
with Right hepatectomy". I understand the sense however this sentence sounds
awkward and should be revised. NB: remanent should be remnant. 
The impression of the Authors is that the pt developed POLF due to the
background chemo-induced liver damage. As the pt received 12 cycles of
oxaliplatin, a comment on the aspect of the liver on the preop CT and about the
macroscopic appearance during the operation (sinusoidal obstruction syndrome?)
should be made.
In the discussion, 
the Authors correctly mention the most important clinical
experience around LT for unresectable CRLMs. It'd be useful to provide more
details about the number and the outcome of cases performed for POLF in
CRLMs pts (expanding the existing paragraph towards the end of the discussion
section).
Limitations of the current case report should be mentioned: short interval of time
between surgery of the primary and LT, acute setting in which the LT was
performed, underestimation of the quality of the background liver when the
decision for an upfront rt hepatectomy was made (instead, the option of a
resection in two stages could be considered: ALPPS or PVL with seg4a
clearance and subsequent rt hepatectomy). I believe that only highlighting these
aspects this case report can add something to the existing knowledge.
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