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

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.