{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:03:00Z","timestamp":1792839780904,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2017,11,20]],"date-time":"2017-11-20T00:00:00Z","timestamp":1511136000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>\n                    A tenth of all pediatric liver transplantations (LTs) are performed for unresectable liver malignancies, especially the more common hepatoblastoma (HBL). Less understood are outcomes after LT for the rare hepatocellular carcinoma, nonhepatoblastoma embryonal tumors (EMBs), and slow growing metastatic neuroendocrine tumors of childhood. Pediatric LT is increasingly performed for rare unresectable liver malignancies other than HBL. We performed a retrospective review of outcomes after LT for malignancy in the multicenter US Scientific Registry of Transplant Recipients (SRTR; n\u2009=\u2009677; 1987\u20102015). We then reviewed the Children's Hospital of Pittsburgh (CHP; n\u2009=\u200974; 1981\u20102014) experience focusing on LT for unresectable hepatocellular cancer (HCC), EMBs, and metastatic liver tumors (METS). HBL was included to provide reference statistics. In the SRTR database, LT for HCC and HBL increased over time (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Compared with other malignancies, the 149 HCC cases received fewer segmental grafts (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001) and also experienced 10\u2010year patient survival similar to 15,710 adult HCC LT recipients (51.6% versus 49.6%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.848, not significant [NS], log\u2010rank test). For 22 of 149 cases with incidental HCC, 10\u2010year patient survival was higher than 127 primary HCC cases (85% [95% confidence interval (CI), 70.6%\u2010100%] versus 48.3% [95% CI, 38%\u201061%];\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.168, NS) and similar to 3392 biliary atresia cases (89.9%; 95% CI, 88.7%\u201091%). Actuarial 10\u2010year patient survival for 17 EMBs, 10 METS, and 6 leiomyosarcoma patients exceeded 60%. These survival outcomes were similar to those seen for HBL. At CHP, posttransplant recurrence\u2010free and overall survival among 25 HCC, 17 (68%) of whom had preexisting liver disease, was 16\/25 or 64%, and 9\/25 or 36%, respectively. All 10 patients with incidental HCC and tumor\u2010node\u2010metastasis stage I and II HCC survived recurrence\u2010free. Only vascular invasion predicted poor survival in multivariate analysis (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.0001). A total of 4 of 5 EMB patients (80%) and all patients with METS (neuroendocrine\u20102, pseudopapillary pancreatic\u20101) also survived recurrence\u2010free. Among children, LT can be curative for unresectable HCC confined to the liver and without vascular invasion, incidental HCC, embryonal tumors, and metastatic neuroendocrine tumors.\n                    <jats:italic toggle=\"yes\">Liver Transplantation 23 1577\u20131588 2017<\/jats:italic>\n                    AASLD.\n                  <\/jats:p>","DOI":"10.1002\/lt.24847","type":"journal-article","created":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T12:02:36Z","timestamp":1502971356000},"page":"1577-1588","source":"Crossref","is-referenced-by-count":52,"title":["Pediatric liver transplantation for hepatocellular cancer and rare liver malignancies: US multicenter and single\u2010center experience (1981\u20102015)"],"prefix":"10.1097","volume":"23","author":[{"given":"Rohan","family":"Vinayak","sequence":"first","affiliation":[{"name":"Department of Surgery, College of Medicine,Medical University of South Carolina,Charleston,SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruy J.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute,University of Pittsburgh Medical Center,Montefiore, Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarangarajan","family":"Ranganathan","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Mohanka","sequence":"additional","affiliation":[{"name":"Liver Transplant and Hepatobiliary Surgery, Global Hospitals,Mumbai,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Mazariegos","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Soltys","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Bond","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh","family":"Tadros","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Humar","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute,University of Pittsburgh Medical Center,Montefiore, Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Wallis","family":"Marsh","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute,University of Pittsburgh Medical Center,Montefiore, Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Selby","sequence":"additional","affiliation":[{"name":"Department of Surgery, Keck School of Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Reyes","sequence":"additional","affiliation":[{"name":"Kidney, Liver, Intestinal Care Services,University of Washington Medical Center,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Sun","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Haberman","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute,University of Pittsburgh Medical Center,Montefiore, Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8525-6694","authenticated-orcid":false,"given":"Rakesh","family":"Sindhi","sequence":"additional","affiliation":[{"name":"Thomas E. Starzl Transplantation Institute, Children's Hospital of Pittsburgh,University of Pittsburgh Medical Center,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,11,20]]},"reference":[{"issue":"pt 2","key":"lt24847-bib-0001-20240115","first-page":"1012","article-title":"SRTR program\u2010specific reports on outcomes: a guide for the new reader","volume":"8","year":"2008","journal-title":"Am J Transplant"},{"key":"lt24847-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.surg.2012.11.006","article-title":"Analysis of national and single\u2010center incidence and survival after liver transplantation for hepatoblastoma: new trends and future opportunities","volume":"153","year":"2013","journal-title":"Surgery"},{"key":"lt24847-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/lt.23803","article-title":"Nationwide survey of the outcomes of living donor liver transplantation for hepatoblastoma in Japan","volume":"20","year":"2014","journal-title":"Liver Transpl"},{"key":"lt24847-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jpedsurg.2005.10.091","article-title":"Liver transplantation for childhood hepatic malignancy: a review of the United Network for Organ Sharing (UNOS) database","volume":"41","year":"2006","journal-title":"J Pediatr Surg"},{"key":"lt24847-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S0022-3476(00)44469-0","article-title":"Liver transplantation and chemotherapy for hepatoblastoma and hepatocellular cancer in childhood and adolescence","volume":"136","year":"2000","journal-title":"J Pediatr"},{"key":"lt24847-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1002\/hep.21287","article-title":"Hepatocellular carcinoma in ten children under five years of age with bile salt export pump deficiency","volume":"44","year":"2006","journal-title":"Hepatology"},{"key":"lt24847-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1111\/j.1399-3046.2007.00751.x","article-title":"Outcomes of transplantation in children with primary hepatic malignancy","volume":"11","year":"2007","journal-title":"Pediatr Transplant"},{"key":"lt24847-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.jpeds.2011.03.004","article-title":"Hepatocellular carcinoma in biliary atresia: King's College Hospital experience","volume":"159","year":"2011","journal-title":"J Pediatr"},{"key":"lt24847-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"2798","DOI":"10.1200\/JCO.2002.06.102","article-title":"Hepatocellular carcinoma in children: results of the first prospective Study of the International Society of Pediatric Oncology group","volume":"20","year":"2002","journal-title":"J Clin Oncol"},{"key":"lt24847-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1002\/pbc.25094","article-title":"HCC prevalence and histopathological findings in liver explants of patients with hereditary tyrosinemia type 1","volume":"61","year":"2014","journal-title":"Pediatr Blood Cancer"},{"key":"lt24847-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/j.1399-3046.2011.01528.x","article-title":"Favorable outcome of primary liver transplantation in children with cirrhosis and hepatocellular carcinoma","volume":"15","year":"2011","journal-title":"Pediatr Transplant"},{"key":"lt24847-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/j.1399-3046.2009.01062.x","article-title":"Liver transplantation in children with hepatocellular carcinoma. Do Milan criteria apply to pediatric patients?","volume":"13","year":"2009","journal-title":"Pediatr Transplant"},{"key":"lt24847-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1200\/JCO.2002.06.155","article-title":"Hepatocellular carcinoma in children and adolescents: results from the Pediatric Oncology Group and the Children's Cancer Group intergroup study","volume":"20","year":"2002","journal-title":"J Clin Oncol"},{"key":"lt24847-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.1016\/j.transproceed.2005.03.060","article-title":"Hepatic angiosarcoma and liver transplantation: case report and literature review","volume":"37","year":"2005","journal-title":"Transplant Proc"},{"key":"lt24847-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/pbc.23295","article-title":"Sorafenib and cisplatin\/doxorubicin (PLADO) in pediatric hepatocellular carcinoma","volume":"58","year":"2012","journal-title":"Pediatr Blood Cancer"},{"key":"lt24847-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/lt.23773","article-title":"Multimodal therapy including liver transplantation for hepatic undifferentiated embryonal sarcoma","volume":"20","year":"2014","journal-title":"Liver Transpl"},{"key":"lt24847-bib-0019-20240115","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/MPH.0b013e318271c948","article-title":"A single\u2010institution retrospective cases series of childhood undifferentiated embryonal liver sarcoma (UELS): success of combined therapy and the use of orthotopic liver transplant","volume":"35","year":"2013","journal-title":"J Pediatr Hematol Oncol"},{"key":"lt24847-bib-0020-20240115","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jpedsurg.2009.09.008","article-title":"Liver transplant for relapsed undifferentiated embryonal sarcoma in a young child","volume":"44","year":"2009","journal-title":"J Pediatr Surg"},{"key":"lt24847-bib-0021-20240115","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1111\/j.1432-2277.2010.01107.x","article-title":"Liver transplantation and vascular tumours","volume":"23","year":"2010","journal-title":"Transpl Int"},{"key":"lt24847-bib-0022-20240115","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1097\/TP.0b013e318281b902","article-title":"Hepatic hemangiosarcoma: an absolute contraindication to liver transplantation\u2010\u2010the European Liver Transplant Registry experience","volume":"95","year":"2013","journal-title":"Transplantation"},{"key":"lt24847-bib-0023-20240115","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/SLA.0b013e31828ee17c","article-title":"Liver transplantation for neuroendocrine tumors in Europe\u2010results and trends in patient selection: a 213\u2010case European liver transplant registry study","volume":"257","year":"2013","journal-title":"Ann Surg"},{"key":"lt24847-bib-0024-20240115","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1245\/s10434-014-3523-y","article-title":"Liver transplantation for unresectable neuroendocrine tumor liver metastases","volume":"21","year":"2014","journal-title":"Ann Surg Oncol"},{"key":"lt24847-bib-0025-20240115","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1001\/archsurg.2011.186","article-title":"Liver transplantation for the treatment of liver metastases from neuroendocrine tumors: an analysis of the UNOS database","volume":"146","year":"2011","journal-title":"Arch Surg"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.24847","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201712000-00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T20:32:35Z","timestamp":1705264355000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201712000-00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,20]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.24847","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,20]]}}}