The outcomes of transplant for metastatic disease in the early days of liver transplantation were dismal.1 Early recurrence was common and 3-year survival was unusual. These results, coupled with a shortage of cadaveric organs for transplant, led to an abandonment of transplant as a treatment option for colorectal liver metastases. In this issue of JAMA Surgery, Dueland and colleagues2 present data that see this treatment in a new light.