Liver transplant is the only treatment for unresectable liver tumors. We present our experiences with using liver transplant to treat 14 children with unresectable liver tumors. Between September 2001 and July 2008, we did 111 liver transplants in 108 children at our center. Fourteen of these 108 children (12.8%6.2 years; age; mean age, 8.2 range, 6 months to 16 years; male-to-female ratio, 8:6) had a preoperatively diagnosed or incidental hepatic tumor that we subsequently analyzed retrospectively. All grafts were obtained from living-related donors. Ten children had hepatocellular carcinoma, 3 had a hepatoblastoma, and 1 had a neuroblastoma causing consumption coagulopathy. The liver tumors were diagnosed before the transplant in 11 children; in 3 children, we identified an incidental tumor. One child had combined hepatic arterial chemoembolization and systemic chemotherapy, and 5 had systemic chemotherapy before the liver transplant. Two children received a right lobe graft, 7 received a left lateral segment graft, and the remaining 5 received a left lobe graft. The pathology findings demonstrated a mean tumor size of 3.3 ± 2.5 cm. The number of tumors was less than 5 in 9 children, and more than 10 in the remaining 5 children. The largest tumor size was 11 cm. Four children had microvascular invasion. One child who had a neuroblastoma causing consumption coagulopathy received systemic chemotherapy after the liver transplant. There have been only 2 tumor recurrences after a liver transplant. One child with a hepatoblastoma experienced lymphoproliferative disease 22 months after his liver transplant. During a mean follow-up of 29.7 ± 15.5 months, 2 children died. At the time of this writing, the remaining 12 children are alive with good graft functioning. In conclusion, liver transplant is a good option for pediatric patients with unresectable hepatic tumors and provides long patient and disease-free survival.
Volume : 6
Issue : 4
Pages : 118
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey