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Published on: March 10, 2023
Liver transplantation for hepatoblastoma
Walid Faraj1, Faisal Dar, Gabriele Marangoni
1Institute of Liver Studies, King's College Hospital, School of Medicine, King's College London, London, UK.
Summary
Liver transplantation offers excellent survival rates for hepatoblastoma. Living donor liver transplantation (LRLT) provides outcomes comparable to cadaveric grafts, establishing it as a viable option for pediatric liver cancer.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Surgery
- Transplantation Immunology
Background:
- Hepatoblastoma is a rare pediatric liver cancer.
- Liver transplantation is a critical treatment for unresectable hepatoblastoma.
- Chemotherapy protocols, such as SIOPEL, are used for risk stratification.
Purpose of the Study:
- To evaluate the outcomes of liver transplantation for hepatoblastoma.
- To compare the efficacy of cadaveric versus living donor liver transplantation (LRLT).
- To assess long-term patient and graft survival rates.
Main Methods:
- Retrospective analysis of 25 liver transplantations for hepatoblastoma (October 1993 - February 2007).
- Categorization of patients by PRETEXT staging (III and IV).
- Administration of preoperative chemotherapy per SIOPEL protocols.
Main Results:
- Patient and graft survival rates for cadaveric grafts: 91% (1 year), 77.6% (5 years), 77.6% (10 years).
- Patient and graft survival rates for LRLT: 100% (1 year), 83.3% (5 years), 83.3% (10 years).
- Most survivors remained disease-free; 5 deaths occurred due to tumor recurrence or respiratory failure.
Conclusions:
- Liver transplantation is an established treatment for chemotherapy-responsive, unresectable hepatoblastoma.
- LRLT is a safe and effective therapeutic option with outcomes similar to cadaveric transplantation.
- Successful LRLT can improve survival for children with hepatoblastoma.
