An analysis of the outcomes in living donor liver transplantation for pediatric malignant hepatic tumors using nationwide survey data in Japan. (22nd June 2021)

• Record Type: Journal Article
• Authors: Uchida, Hajime; Sakamoto, Seisuke; Kasahara, Mureo; Ueno, Yoshiyuki; Mochida, Satoshi; Haga, Hironori; Okajima, Hideaki; Eguchi, Susumu; Takada, Yasutsugu; Umeshita, Koji; Kokudo, Norihiro; Egawa, Hiroto; Uemoto, Shinji; Ohdan, Hideki
• Is Part Of: Transplant international. Volume 34:Number 8(2021)
• Page Start: 1408
• Page End: 1421
• Publication Date: 2021-06-22
• Subjects: live donors -- liver -- liver clinical -- malignancies and long term compliations -- pediatric transplantation -- solid tumors; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13924
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: Malignant hepatic tumors (MHTs) in children are rare and account for approximately 5% of candidates for pediatric liver transplantation (LT) in Japan. We conducted a national survey of pediatric patients undergoing living donor LT for MHTs between October 1990 and April 2018. In total, 116 children underwent LT for MHTs during this study period: 100 hepatoblastomas (HBLs), 10 hepatocellular carcinomas (HCCs), and six other MHTs. The overall patient survival rate at 5 years was 81.3% for HBL, 60.0% for HCC, and 80.0% for other MHTs ( P = 0.047). In patients with HBL, there was no significant difference in the 1‐ and 5‐year patient survival rates between patients undergoing primary LT and those who received salvage LT for tumor recurrence (89.7%, 81.6% vs. 88.0%, 76%; P = 0.526). The 5‐year overall survival rate after LT for HBL significantly improved from 63.2% in 1996–2008 to 89.8% in 2009–2018 ( P = 0.018). The presence of lung metastasis before LT had no significant influence on the long‐term survival ( P = 0.742). Five patients with HCC died, including two who fell outside the Milan criteria. In conclusion, LT for pediatric MHTs, especially HBL, is a valuable treatment option for select patients. Abstract : Living donor liver transplantation can make it possible for the patient selection criteria to be tailored to each patient's tumor condition. Liver transplantation for pediatric malignant hepatic tumors, especially hepatoblastoma, is a valuable treatment option for select patients.