Living donor liver transplantation for hepatic malignancies in children
© 2021 Wiley Periodicals LLC..
BACKGROUND: Living donor liver transplantation is a treatment option for unresectable hepatic tumors in children.
METHODS: We enrolled 45 living donor transplantations performed between 1993 and 2018 for liver malignacies, which included hepatoblastoma (n = 33), hepatocellular carcinoma (n = 10), hepatic angiosarcoma (n = 1), and rhabdomyosarcoma (n = 1).
RESULTS: No mortality or major morbidities were encountered in any donor, and the complication rate was 9%. In the hepatoblastoma group, 5-year overall and event-free survival rate in recipients was 87.4% and 75.8%, respectively, and mortality was significantly higher in patients after rescue transplantation (p = .001). Inferior vena cava replacement in these recipients appeared to be associated with reduced mortality (p = .034), but this was not confirmed when rescue patients were excluded (p = .629). In hepatocellular carcinoma group, both 5-year overall and event-free survival rates were 75.4% each, and invasion of hepatic veins was significantly associated with increased risk of recurrence and death (p = .028). The patient with rhabdomyosarcoma died from EBV-induced lymphoma 2 months after transplantation. The patient with angiosarcoma was in complete remission at the last follow-up. Overall, 5-year graft survival rate was 81.3%, and one patient underwent re-transplantation due to chronic rejection.
CONCLUSIONS: Pediatric oncological liver transplantation has become a key player in the management of malignancies with cancer cure in 84% of patients in this series. Living donor liver transplantation for pediatric recipients with unresectable tumors might be a beneficial surgical option, which is technically safe for donors and recipients, thus, allowing timely planning according to chemotherapy protocols.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
Pediatric transplantation - 25(2021), 7 vom: 22. Nov., Seite e14047 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pire, Aurore [VerfasserIn] |
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| Links: |
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| Themen: |
Hepatoblastoma |
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| Anmerkungen: |
Date Completed 02.02.2022 Date Revised 02.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/petr.14047 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM326253793 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND: Living donor liver transplantation is a treatment option for unresectable hepatic tumors in children | ||
| 520 | |a METHODS: We enrolled 45 living donor transplantations performed between 1993 and 2018 for liver malignacies, which included hepatoblastoma (n = 33), hepatocellular carcinoma (n = 10), hepatic angiosarcoma (n = 1), and rhabdomyosarcoma (n = 1) | ||
| 520 | |a RESULTS: No mortality or major morbidities were encountered in any donor, and the complication rate was 9%. In the hepatoblastoma group, 5-year overall and event-free survival rate in recipients was 87.4% and 75.8%, respectively, and mortality was significantly higher in patients after rescue transplantation (p = .001). Inferior vena cava replacement in these recipients appeared to be associated with reduced mortality (p = .034), but this was not confirmed when rescue patients were excluded (p = .629). In hepatocellular carcinoma group, both 5-year overall and event-free survival rates were 75.4% each, and invasion of hepatic veins was significantly associated with increased risk of recurrence and death (p = .028). The patient with rhabdomyosarcoma died from EBV-induced lymphoma 2 months after transplantation. The patient with angiosarcoma was in complete remission at the last follow-up. Overall, 5-year graft survival rate was 81.3%, and one patient underwent re-transplantation due to chronic rejection | ||
| 520 | |a CONCLUSIONS: Pediatric oncological liver transplantation has become a key player in the management of malignancies with cancer cure in 84% of patients in this series. Living donor liver transplantation for pediatric recipients with unresectable tumors might be a beneficial surgical option, which is technically safe for donors and recipients, thus, allowing timely planning according to chemotherapy protocols | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a hepatoblastoma | |
| 650 | 4 | |a living donor liver transplantation | |
| 650 | 4 | |a malignancy | |
| 700 | 1 | |a Tambucci, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a De Magnée, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Sokal, Etienne |e verfasserin |4 aut | |
| 700 | 1 | |a Stephenne, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Scheers, Isabelle |e verfasserin |4 aut | |
| 700 | 1 | |a Zech, Francis |e verfasserin |4 aut | |
| 700 | 1 | |a Gurevich, Micheal |e verfasserin |4 aut | |
| 700 | 1 | |a Brichard, Bénédicte |e verfasserin |4 aut | |
| 700 | 1 | |a Reding, Raymond |e verfasserin |4 aut | |
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