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: 
0 
Date: 
24 Nov 2020
Reviewer's report:
The Authors describe the case of a patient with post-operative liver failure
(POLF) after right hepatectomy for CRLMs, salvaged with liver transplantation.
I have several reservations regarding the description and the management of the
patient:
- The Authors should detail the reason for opting for a Rt hepatectomy.
Otherwise my impression is that the metastatic lesions are of limited size and
could probably be treated with a more limited resection rather than with a right
hepatectomy (also the position of the lesions, looking at the few PET-CT images,
seem to allow a parenchyma sparing approach); especially in such a young
patient, the need to preserve as much parechyma as possible is pivotal in view of
expected further resection, due to the natural history of the disease; as an
example, is there any CT scan image that show the main met being in contact
wih the right portal branch?
- in the context of 12 cycles history of chemo, did the Authors assess the
background liver function with any test preoperatively (e.g. ICG-RR15, LiMAx,
or similar)? Did they consider inducing hypertrophy in the future liver remnant
(e.g. PVL, PVE, ALPPS, or alternatives)? These should be commented in the
text;
- the background liver in the specimen was normal, therefore unlikely to develop
POLF if more than 50% of parenchyma was preserved, as the Authors stated;
were there any vascular or other type of complications in the liver that could
justify the acute liver failure? What is the impression of the authors regarding the
cause of the POLF? When did POLF develop (post-op day)? 
- Did the Authors have more detailed information about the histology of the
primary tumor (mutations, MSI, KRAS, BRAF) that could aid the decision to
proceed to salvage transplantation with acceptable risk of futility? 
- What type of OLT was performed (deceased, living, DBD, DCD)? It'd be
useful to provide the reader with some background regarding OLT in Saudi
Arabia and what are the local policies so that the decision to offer OLT is framed
in context. 
Minor comments: 
- English native speaker editing is required. Some capital letters are used
liberally.
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