Treatment of unresectable hepatoblastoma with liver transplantation in the pediatric population

Ernesto P. Molmenti, Krissy Wilkinson, Hebe Molmenti, Jay S. Roden, Robert H. Squires, Carlos G. Fasola, Gail Tomlinson, David E. Nagata, Lisa D'Amico, M. James Lopez, Leo M. Savino, Shigeru Marubashi, Edmund Q. Sanchez, Robert M. Goldstein, Marion F. Levy, Walter Andrews, John A. Andersen, Goran B. Klintmalm

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

The purpose of our study was to evaluate the outcome of children who underwent liver transplantation as treatment for unresectable hepatoblastoma. We prospectively collected data on 311 consecutive liver transplants performed at Children's Medical Center of Dallas between October 1984 and November 2000. There were nine recipients (five boys, four girls) with a diagnosis of unresectable hepatoblastoma. Postoperative survival of those currently alive ranged from 6 months to 16 years (mean 6.4 years, median 7.7 years). All recipients received preoperative chemotherapy; 67% received postoperative chemotherapy. Mean AFP level prior to transplantation was 1 448 000 ng/mL. Mean age at diagnosis was 0.81 years. Mean age at transplantation was 1.87 years. Only two patients experienced acute cellular rejection in the postoperative period. There was a total of three deaths and one recurrence. The only instance in which AFP levels did not decrease to low or undetectable levels post-transplantation was in the patient with recurrent tumor. Liver transplantation has an established role in the treatment of hepatoblastoma. It accounted for 3% of pediatric liver transplants, and provided the only opportunity for survival in otherwise incurable patients. Early diagnosis and treatment were found to be associated with better results. Response to chemotherapy may be an important factor influencing survival. Rising AFP levels after transplantation are associated with recurrence.

Original languageEnglish (US)
Pages (from-to)535-538
Number of pages4
JournalAmerican Journal of Transplantation
Volume2
Issue number6
DOIs
StatePublished - Jul 2002

Keywords

  • Alfa-fetoprotein
  • Chemotherapy
  • Hepatoblastoma
  • Liver transplantation
  • Malignancy
  • Pediatric

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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