Successful liver transplantation after induction chemotherapy in children with inoperable, multifocal primary hepatic malignancy
Laine, J.; Jalanko, H.; Saarinen-Pihkala, U.M.; Höckerstedt, K.; Leijala, M.; Holmberg, C.; Heikinheimo, M.
Transplantation 67(10): 1369-1372
1999
ISSN/ISBN: 0041-1337 PMID: 10360593 Document Number: 506378
Background. The prognosis for primary epithelial liver tumor in children in whom radical surgery cannot be performed after chemotherapy is poor. Orthotopic liver transplantation has resulted in mortality up to 50%, largely as a result of problems in determining the criteria for transplantation. Methods. We report results on liver transplantation for primary epithelial liver malignancy in five children (mean age at transplantation: 6.0 years). Only patients with inoperable residual tumor in the liver after four cycles of multidrug chemotherapy, but without extrahepatic infiltration or metastases, were considered eligible for transplantation. Results. Mean follow-up was 4.6 years. Patient and graft survival was 100%, with no signs of residual or de novo malignancy. Conclusion. In children with inoperable primary liver malignancy with no extrahepatic tumor growth, orthotopic liver transplantation has an excellent outcome.