Introduction: The current role of liver transplantation in treating malignant tumors of the liver is uncertain, except for selective histologic types. Hepatoblastoma is the most common malignant liver tumor of early childhood accounting for 60%-85% of all hepatic tumors in children. More than 60% of lesions that appear unresectable on initial imaging will shrink with chemotherapy and become resectable. However, approximately 20% of tumors remain unresectable after chemotherapy and the liver transplantation is the only curative option in these cases.The aim of this study was to review the clinicopathological findings in 5 children who underwent liver transplantation for hepatoblastoma.

Materials and Methods: We analysed retrospectively 408 patients who had liver transplantation between January 1990 and December 2012. Only five of 187 (2.6%) pediatric liver transplant patients underwent liver transplantation with the diagnosis of hepatoblastoma. Clinicopathologic findings of these cases including age, gender, chemoterapeutic regimen, stage and histopathologic subtypes of the hepatoblastoma were recorded.

Results: The study group included 2 female and 3 male patients of mean age at the transplantation of 44.2 ±27.8 months (range, 14-75 months). All of these 5 cases treated first of all with the cisplatin. In addition to cisplatin 2 of 5 cases also admitted to adriamycine and 3 of them also received doxorubicin. After chemoterapy, radiological examinations showed no regression of the tumor.Thus, all of these cases were accepted as unresectable tumor and underwent liver transplantation. Histopathological study of the native livers of all 5 cases showed pure epithelial type (fetal and embryonal) hepatoblastoma in 3 cases, mixt epithelial and mesenchimal type hepatoblastoma in remaining 2 patients. The mean follow-up time for all patients was 30.17±29 months (range,3-71 months). During follow-up neither acute nor chronic rejection was found in any case. But, one patient had developed post-transplant lenfoproliferative disease (PTLD) after 2 years of the liver transplantation and he was died because of the PTLD. Two of 5 patients were died because of the hepatoblastoma and remaining 2 of 5 patients are still alive without liver failure.

Conclusions: Chemotherapy and/or resection of the tumor may be curable for some hepatoblastoma patients but some cases do not have any chance with these treatment modalities. Such cases were accepted as unresectable and the only treatment left for these cases is liver transplantation.