title: Successful liver transplantation after induction chemotherapy in children with inoperable, multifocal primary hepatic malignancy.
abstract: 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.
  
  
  CONCLUSIONS
  In children with inoperable primary liver malignancy with no extrahepatic tumor growth, orthotopic liver transplantation has an excellent outcome.
authors.affiliation: Hospital for Children and Adolescents, University of Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Laine
authors.forename: H
authors.initials: H
authors.lastname: Jalanko
authors.forename: U M
authors.initials: UM
authors.lastname: Saarinen-Pihkala
authors.forename: K
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: M
authors.initials: M
authors.lastname: Leijala
authors.forename: C
authors.initials: C
authors.lastname: Holmberg
authors.forename: M
authors.initials: M
authors.lastname: Heikinheimo
mesh_terms: D000293:Adolescent; D001157:Arterial Occlusive Diseases / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000188:drug therapy / Q000503:physiopathology; D006499:Hepatic Artery; D006801:Humans; D007223:Infant; D007417:Intestinal Polyps / Q000209:etiology; D007511:Ischemia / Q000209:etiology; D008100:Liver Abscess / Q000209:etiology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D011788:Quality of Life; D014184:Transplantation, Homologous / Q000502:physiology