{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:20:29Z","timestamp":1791937229620,"version":"4.3.4"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T00:00:00Z","timestamp":1674345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The incidence of pediatric liver tumors in general has been rising over the last years and so is the number of children undergoing liver transplantation for this indication. To contribute to the ongoing improvement of pre- and post-transplant care, we aim to describe outcome and risk factors in our patient cohort. We have compared characteristics and outcome for patients transplanted for hepatoblastoma to other liver malignancies in our center between 1983 and 2022 and analysed influential factors on tumor recurrence and mortality using nominal logistic regression analysis. Of 39 children (16 f) who had transplants for liver malignancy, 31 were diagnosed with hepatoblastoma. The proportion of malignant tumors in the transplant cohort rose from 1.9% (1983\u20131992) to 9.1% in the current decade (p &lt; 0.0001). Hepatoblastoma patients were transplanted at a younger age and were more likely to have tumor extent beyond the liver. Post-transplant bile flow impairment requiring intervention was significantly higher compared to our total cohort (48 vs. 24%, p &gt; 0.0001). Hearing loss was a common side effect of ototoxic chemotherapy in hepatoblastoma patients (48%). The most common maintenance immunosuppression were mTor-inhibitors. Risk factors for tumor recurrence in patients with hepatoblastoma were higher AFP before transplant (AFPpre-LTX), a low ratio of AFPmax to AFPpre-LTX and salvage transplantation. Liver malignancies represent a rising number of indications for liver transplantation in childhood. Primary tumor resection can spare a liver transplant with all its long-term complications, but in case of tumor recurrence, transplantation might have inferior outcome. The rate of acute biopsy-proven rejections and biliary complications in comparison to our total transplant cohort needs further investigations.<\/jats:p>","DOI":"10.3390\/children10020202","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T02:01:02Z","timestamp":1674439262000},"page":"202","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long-Term Outcome Following Liver Transplantation for Primary Hepatic Tumors\u2014A Single Centre Observational Study over 40 Years"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-8728","authenticated-orcid":false,"given":"Christoph","family":"Leiskau","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology, Department of Pediatrics and Adolescent Medicine, University Medical Centre G\u00f6ttingen, Georg August University Goettingen, 37075 Goettingen, Germany"},{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3099-2667","authenticated-orcid":false,"given":"Norman","family":"Junge","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frauke E.","family":"Mutschler","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Laue","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-7656","authenticated-orcid":false,"given":"Johanna","family":"Ohlendorf","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian W. R.","family":"Vondran","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva-Doreen","family":"Pfister","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Baumann","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany"},{"name":"Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.2741\/e395","article-title":"Treatment of Hepatoblastoma in the German Cooperative Pediatric Liver Tumor Studies","volume":"4","author":"Haeberle","year":"2012","journal-title":"Front. Biosci.-Elite"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.jpedsurg.2006.12.065","article-title":"Outcomes of Primary Liver Cancer in Children: An Appraisal of Experience","volume":"42","author":"Pham","year":"2007","journal-title":"J. Pediatr. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e29763","DOI":"10.1002\/pbc.29763","article-title":"Incidence and 5-Year Survival of Children and Adolescents with Hepatoblastoma in the United States","volume":"69","author":"Kahla","year":"2022","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40880-019-0411-7","article-title":"Incidence Trends and Survival Prediction of Hepatoblastoma in Children: A Population-Based Study","volume":"39","author":"Feng","year":"2019","journal-title":"Cancer Commun."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e2022057424","DOI":"10.1542\/peds.2022-057424","article-title":"Prognosis of Children Undergoing Liver Transplantation: A 30-Year European Study","volume":"150","author":"Baumann","year":"2022","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Leiskau, C., Junge, N., Pfister, E.D., Goldschmidt, I., Mutschler, F., Laue, T., Ohlendorf, J., Nasser, H., Beneke, J., and Richter, N. (2021). Recipient-Specific Risk Factors Impairing Patient and Graft Outcome after Pediatric Liver Transplantation-Analysis of 858 Transplantations in 38 Years. Children, 8.","DOI":"10.3390\/children8080641"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1002\/lt.24847","article-title":"Pediatric Liver Transplantation for Hepatocellular Cancer and Rare Liver Malignancies: US Multicenter and Single-Center Experience (1981\u20132015)","volume":"23","author":"Vinayak","year":"2017","journal-title":"Liver Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e13605","DOI":"10.1111\/petr.13605","article-title":"Society of Pediatric Liver Transplantation: Current Registry Status 2011\u20132018","volume":"24","author":"Elisofon","year":"2020","journal-title":"Pediatr. Transpl."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jpedsurg.2017.10.035","article-title":"Liver Transplantation for Primary Hepatic Malignancies of Childhood: The UNOS Experience","volume":"53","author":"Hamilton","year":"2017","journal-title":"J. Pediatr. 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Hepatol., 1.","DOI":"10.21037\/tgh.2016.04.01"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e13113","DOI":"10.1111\/petr.13113","article-title":"Prognostic and Therapeutic Factors Influencing the Clinical Outcome of Hepatoblastoma after Liver Transplantation: A Single-Institute Experience","volume":"22","author":"Umeda","year":"2018","journal-title":"Pediatr. Transpl."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e13250","DOI":"10.1111\/petr.13250","article-title":"Long-Term Outcomes of Liver Transplantation for Hepatoblastoma: A Single-Center 14-Year Experience","volume":"22","author":"LaQuaglia","year":"2018","journal-title":"Pediatr. Transpl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/MOP.0000000000000081","article-title":"Management of Hepatoblastoma: An Update","volume":"26","author":"Kremer","year":"2014","journal-title":"Curr. Opin. 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Med."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/2\/202\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:13:32Z","timestamp":1760120012000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/2\/202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,22]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["children10020202"],"URL":"https:\/\/doi.org\/10.3390\/children10020202","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,22]]}}}