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Liver transplantation for pediatric liver malignancies
Seisuke Sakamoto1, Sakthivel Harikrishnan, Hajime Uchida
1Organ Transplantation Center, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
Summary
Liver transplantation (LT) is the standard for unresectable pediatric liver tumors, offering over 80% survival for hepatoblastoma. Living donor liver transplantation has further improved outcomes for these rare childhood cancers.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Surgery
- Transplantation Medicine
Background:
- Liver transplantation (LT) has evolved into a critical treatment for pediatric liver tumors.
- International collaboration has significantly improved survival rates in pediatric oncology.
- Hepatoblastoma and hepatocellular carcinoma (HCC) are primary indications for LT in children.
Purpose of the Study:
- To review the role and outcomes of liver transplantation for pediatric liver malignancies.
- To highlight advancements in LT, including living donor liver transplantation (LDLT).
- To emphasize the need for multidisciplinary approaches in managing these rare cancers.
Main Methods:
- Review of outcomes following liver transplantation for pediatric liver tumors.
- Analysis of survival rates for hepatoblastoma and HCC.
- Comparison of LT outcomes versus liver resection.
Main Results:
- LT offers long-term survival rates exceeding 80% for hepatoblastoma.
- Living donor liver transplantation has reduced waitlist mortality and improved graft quality.
- LT demonstrates superior outcomes compared to liver resection for unresectable pediatric HCC, even beyond Milan criteria.
Conclusions:
- Liver transplantation is the established standard of care for unresectable pediatric liver tumors.
- Advancements like LDLT have enhanced treatment efficacy and accessibility.
- Further research and multidisciplinary collaboration are essential for improving outcomes in pediatric liver malignancies.
