title: Liver transplantation in tyrosinaemia type 1: the dilemma of timing the operation.
abstract: Four children with tyrosinaemia type 1 received liver transplants. The metabolic disorder was corrected and all four had normal liver function on an unrestricted diet. Two children, transplanted at age five and seven years, proved to have occult hepatocellular carcinoma and both subsequently developed pulmonary metastases. One child was well 32 months after removal of a single pulmonary metastasis but the other child died with multiple metastases. The two younger children, transplanted at age 19 and 21 months, were well 28 and 44 months after operation, one after a second liver transplant. Our experience confirms the high risk of hepatocellular carcinoma in this disease and the potential value of early liver transplantation.
authors.affiliation: Department of Paediatrics, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: A
authors.initials: A
authors.lastname: Salt
authors.forename: N D
authors.initials: ND
authors.lastname: Barnes
authors.forename: K
authors.initials: K
authors.lastname: Rolles
authors.forename: R Y
authors.initials: RY
authors.lastname: Calne
authors.forename: P T
authors.initials: PT
authors.lastname: Clayton
authors.forename: J V
authors.initials: JV
authors.lastname: Leonard
mesh_terms: D000367:Age Factors; D000592:Amino Acid Metabolism, Inborn Errors / Q000150:complications / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology; D016031:Liver Transplantation; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D014443:Tyrosine / Q000097:blood*
chemical_list: D014443:Tyrosine