Living donor liver transplantation for hepatic malignancies in children
Abstract 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 |
| Beteiligte Personen: |
Pire, Aurore [VerfasserIn] |
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| BKL: |
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| Anmerkungen: |
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
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| Umfang: |
11 |
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| doi: |
10.1111/petr.14047 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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WLY012267635 |
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| 520 | |a Abstract 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. | ||
| 700 | 1 | |a Tambucci, Roberto |4 aut | |
| 700 | 1 | |a De Magnée, Catherine |4 aut | |
| 700 | 1 | |a Sokal, Etienne |4 aut | |
| 700 | 1 | |a Stephenne, Xavier |4 aut | |
| 700 | 1 | |a Scheers, Isabelle |4 aut | |
| 700 | 1 | |a Zech, Francis |4 aut | |
| 700 | 1 | |a Gurevich, Michael |4 aut | |
| 700 | 1 | |a Brichard, Bénédicte |4 aut | |
| 700 | 1 | |a Reding, Raymond |4 aut | |
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