{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:40:35Z","timestamp":1792176035536,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatoblastoma (HBA) is a rare pediatric malignancy treatable with liver transplantation (LTx). Limited data exist on outcomes after LTx for HBA. This study evaluates the therapeutic efficacy of LTx in pediatric patients with HBA, delineates principal complications, and assesses long\u2010term psychosocial outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study analyzed a prospectively maintained database of children undergoing LTx for HBA at a single US center from 1984 to 2025. Primary outcomes were patient and graft survival at 1, 5, and 10\u2009years post\u2010LTx and HBA recurrence. Secondary outcomes included post\u2010LTx complications, recurrence predictors, and psychosocial parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 55 patients (60% female; 40% Hispanic; mean age at diagnosis, 36\u2009months), most had PRETEXT stage III (44%) or IV (47%) disease; mean \u03b1\u2010fetoprotein level at diagnosis was 569\u2009355\u2009ng\/mL. All but 1 received chemotherapy; 15 (27%) had pre\u2010LTx resection. Mean wait time to LTx was 10\u2009months. Pre\u2010LTx metastatic disease (pulmonary) was present in 5 patients (9%). Explant pathology showed macrovascular invasion (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916), positive lymph nodes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), and extra\u2010hepatic tumor invasion\/rupture (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). Post\u2010LTx complications included HBA recurrence (20%), hepatic artery thrombosis (11%), and biliary stricture (20%). Patient survival was 89% at 1\u2009year, 74% at 5 and 10\u2009years; graft survival was 89%, 73%, and 73%, respectively. Significant predictors of recurrence were older age at LTx (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), longer waiting time to LTx (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), prior resection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), larger tumor size (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), vascular invasion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), and utilization of a segmental graft (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Mortality was mainly due to recurrence. Psychosocially, 14 patients needed special education, 10 had developmental delays, 5 of 12 adults completed high school, 2 earned college degrees, and 3 are employed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This large single\u2010center study demonstrates favorable survival after LTx for high\u2010risk HBA. Recurrence predictors support avoiding pre\u2010LTx resection in high\u2010risk cases. While living donor or split grafts can expedite transplantation, segmental grafts were independently linked to higher recurrence. Notably, metastases at diagnosis did not increase recurrence, supporting aggressive treatment. The rate of HAT and biliary stricture was significantly higher for children transplanted for HBA than for our overall pediatric experience. These findings help guide the management of this rare malignancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70354","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T07:32:38Z","timestamp":1780299158000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Excellent Outcomes With High\u2010Risk Pediatric Hepatoblastoma: A Detailed Analysis of a Large, Single\u2010Center Experience"],"prefix":"10.1111","volume":"30","author":[{"given":"Valeria","family":"Ripa","sequence":"first","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Venick","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Pediatric Gastroenterology  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Ebaid","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Federman","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Charland","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin J.","family":"Thornley","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7877-4104","authenticated-orcid":false,"given":"Jonathan","family":"Jou","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Pearson","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vatche G.","family":"Agopian","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fady M.","family":"Kaldas","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne V.","family":"McDiarmid","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Pediatric Gastroenterology  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas G.","family":"Farmer","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Transplant Surgery  Los Angeles California 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