title: Favorable outcome of primary liver transplantation in children with cirrhosis and hepatocellular carcinoma.
abstract: The outcome of HCC after transplantation (OLT) in children is not well known. Unfavorable features based on adult reports may lead to contraindicate OLT even in children. We reviewed a cohort of children with cirrhosis and HCC to evaluate their outcome after primary transplantation. We considered children with cirrhosis and HCC who had a primary OLT. We retrospectively recorded demographic, medical and surgical features, and MC as predictors of outcome. Among 456 children transplanted in the last 15 yr, 10 (2%), median age at diagnosis 1.8 yr (range 0.5-7.2), had HCC in biliary atresia (3), BSEP deficiency (3), tyrosinemia type 1 (2), complications of choledocal cyst and glycogen storage disease type IV (1 each). At HCC discovery, median AFP was 2322 ng/mL (3-35,000), high or rising in 9/10 patients. Six patients were outside the MC. Median time on the waiting list was 38 days (1-152). Two patients died from early complications of OLT. In the other eight patients, there was no tumor recurrence after a median follow-up of four yr. Children with cirrhosis may develop HCC at a very young age. The outcome appears excellent even outside MC. Primary liver transplantation is advisable for children with cirrhosis, HCC, and no extrahepatic disease.
authors.affiliation: Department of Surgical Science, S. Gerardo Hospital, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Romano
authors.forename: Paola
authors.initials: P
authors.lastname: Stroppa
authors.forename: Michela
authors.initials: M
authors.lastname: Bravi
authors.forename: Valeria
authors.initials: V
authors.lastname: Casotti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lucianetti
authors.forename: Michela
authors.initials: M
authors.lastname: Guizzetti
authors.forename: Aurelio
authors.initials: A
authors.lastname: Sonzogni
authors.forename: Michele
authors.initials: M
authors.lastname: Colledan
authors.forename: Lorenzo
authors.initials: L
authors.lastname: D'Antiga
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008103:Liver Cirrhosis / Q000628:therapy*; D008113:Liver Neoplasms / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents