In the current issue of American Journal of Transplantation, McMillan et al. analyze the survival after liver transplantation (LT) for patients with locally-advanced, unresectable, intrahepatic cholangiocarcinoma (iCCA), building upon their earlier experience.1,2 iCCA has long represented a contraindication for LT due to historically poor results, largely driven by an absence of strict selection criteria and limited understanding of tumor biology. The re-appraisal of LT as a curative-treatment modality for iCCA has been catalyzed by favorable oncologic results in patients with iCCA discovered after LT in several single- and multi-institutional studies. Many iCCA patients present with locally advanced disease that precludes resection, resulting in dismal outcomes. Available treatment options for these patients include systemic and locoregional therapy – none of which have curative potential.