Non-resectable hepatic tumors in children - role of liver transplantation.
BACKGROUND
There is a group of children with primary hepatic tumors which can not be resected by conventional partial liver resection. Total hepatectomy followed by liver transplantation may be the only solution in such cases. Authors reviewed own experience with the liver transplantation for unresectable tumors in children and assessed the possible indications and role of transplantation in these patients.


METHODS
Liver transplantation was performed in 17 children with unresectable hepatic tumors out of total number of 350 children transplanted. Hepatocarcinoma was present in 8 children, hepatoblastoma in 6 and benign giant hemangioma in 3. There was no other option for the treatment which would lead to the oncological cure of children with malignant tumors. All patients with giant hemangiomas were infants transplanted urgently due to circulatory and then multiorgan failure.


RESULTS
Survival within whole group is 75.5% (13 of 17 pts), 3 children died of malignant tumor recurrence, one of other causes. All 3 children with benign tumors are alive and well. Actual follow-up is from 3 months to 7 years.


CONCLUSIONS
Liver transplantation should be considered as option in the treatment of all children with unresectable hepatic tumors. With the careful and individual patient selection significant chances for survival can be achieved in this group of patients which would otherwise not survive with the conventional treatment.
Department of Pediatric Surgery and Organ Transplantation, Childrens Memorial Health Institute, Warsaw, Poland. p.kalicinski@czd.pl
Piotr
P
Kaliciński
Hor
H
Ismail
Dorota
D
Broniszczak
Joanna
J
Teisserye
Ludmiła
L
Bacewicz
Małgorzata
M
Markiewicz-Kijewska
Marek
M
Szymczak
Paweł
P
Nachulewicz
Bozenna
B
Dembowska-Bagińska
Przemysław
P
Kluge
Andrzej
A
Kościesza
Adam
A
Kowalski
Marek
M
Stefanowicz
Weronika
W
Kasprzyk
Marek
M
Krawczyk
D000293:Adolescent; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006391:Hemangioma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006498:Hepatectomy; D018197:Hepatoblastoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation; D012189:Retrospective Studies; D015996:Survival Rate