Transplantation 1999 May 27;67(10):1369-72

Successful liver transplantation after induction chemotherapy in children with
inoperable, multifocal primary hepatic malignancy

Laine J, Jalanko H, Saarinen-Pihkala UM, Hockerstedt K, Leijala M, Holmberg C,
Heikinheimo M

Hospital for Children and Adolescents, University of Helsinki, Finland.

Abstract
BACKGROUND: The prognosis for primary epithelial liver tumor in children in whom
radical surgery cannot be performed after chemotherapy is poor. Orthotopic liver
transplantation has resulted in mortality up to 50%, largely as a result of
problems in determining the criteria for transplantation. METHODS: We report
results on liver transplantation for primary epithelial liver malignancy in five
children (mean age at transplantation: 6.0 years). Only patients with inoperable
residual tumor in the liver after four cycles of multidrug chemotherapy, but
without extrahepatic infiltration or metastases, were considered eligible for
transplantation. RESULTS: Mean follow-up was 4.6 years. Patient and graft
survival was 100%, with no signs of residual or de novo malignancy. CONCLUSION:
In children with inoperable primary liver malignancy with no extrahepatic tumor
growth, orthotopic liver transplantation has an excellent outcome