Liver transplantation (LT) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) yield comparable survival outcomes for colorectal liver metastases (CRLM).

• Median overall survival after ALPPS was 76 months vs. 72.7 months for LT.
• After adjusting for biases, ALPPS showed a higher risk of death (HR=1.40), but no significant difference in survival was confirmed (p=0.398).

Consider patient selection carefully: those with failed ALPPS had significantly lower survival rates (31.1 months) compared to LT (p=0.043).

• Outcomes improved for selected ALPPS patients under updated criteria, but LTs not meeting those criteria showed similar results to ALPPS.