Clinical Programs Update

Stanford GI is pleased to introduce ALTO — Advanced Liver Tumor and Transplant Oncology, a new multidisciplinary clinic for patients with primary or metastatic liver tumors, including those being evaluated for transplant oncology candidacy. The clinic is spearheaded by Dr. Dhanasekaran, Director of Stanford's Liver Mass Clinic; Dr. Daugherty, Medical Director of Liver Transplant; Dr. Heestand of GI Oncology; and Dr. Visser and Dr. Sasaki of Hepatobiliary and Transplant Surgery.

Historically, these patients have needed separate visits with hepatology, oncology, surgery, and interventional radiology (IR) — often spread over several weeks — before a treatment plan could be finalized. The ALTO clinic brings all four specialties together in one visit, so decisions are made in real time rather than sequentially. Patients leave with a single, coordinated plan instead of a string of redundant appointments, and the clinic serves as the implementation arm of the liver tumor board, ensuring board recommendations are acted on promptly rather than simply documented.

Who Needs to Be Seen in the Multidisciplinary Clinic (MDC)?

Patients with complex decision points — around treatment sequencing, transplant candidacy, or multimodal therapy — should be referred directly to the ALTO Clinic:

-       Advanced HCC: tumors beyond traditional transplant criteria (e.g., beyond UNOS downstaging criteria) where downstaging, systemic therapy, or Loco-regional therapy (LRT) is being considered, and newly diagnosed multifocal or macrovascular invasive disease.

-       Cholangiocarcinoma (intrahepatic or perihilar): candidates for neoadjuvant therapy or transplant, or cases requiring coordination of systemic therapy, LRT, and surgical timing.

-       Colorectal liver metastases: transplant candidates under clinical or protocol-based indications, and complex or borderline resectable cases weighing LRT vs. resection vs. transplant.

-       Neuroendocrine liver metastases: patients being considered for transplant, embolization, or systemic therapy integration.

-       Any patient with advanced liver tumors being considered for transplant.

For Referring Physicians

PHYSICIAN HELPLINE

Phone: 1-866-742-4811
Fax: 650-320-9443
Monday–Friday, 8 a.m.–5 p.m.

Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referral Information.

You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or email the Referral Center at ReferralCenter@stanfordhealthcare.org.