{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:19:42Z","timestamp":1791937182254,"version":"4.3.4"},"reference-count":17,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"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 aim of this study was to assess the long-term results of liver transplantation (LT) in pediatric patients with unresectable hepatoblastoma (HB) or hepatocellular carcinoma (HCC) with special reference to the risk of tumor recurrence. We retrospectively analyzed data from 46 HB and 26 HCC patients who underwent LT between 1990 and 2022. In HCC patients, we compared outcomes depending on donor type. We evaluated the impact of a number of risk factors on recurrence-free survival after LT. Estimated patient survival after 5, 10, and 15 years was 82%, 73%, and 73% in the HB group and 79%, 75%, and 75% in the HCC group, respectively (p = 0.76). In the HCC group, living donor LT (LDLT) and deceased donor LT (DDLT) provided similar patient survival (p = 0.09). Estimated recurrence-free survival in patients who had three or fewer risk factors was significantly better than in patients with more than three risk factors (p = 0.0001). Adequate patient selection is necessary when considering LT for primary liver tumors in children. The presence of more than three risk factors is associated with a very high risk of recurrence and indicates poor prognosis, whereas extrahepatic disease may be considered a contraindication for transplantation.<\/jats:p>","DOI":"10.3390\/children11020193","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T05:22:44Z","timestamp":1707110564000},"page":"193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk for Recurrence in Long-Term Follow-Up of Children after Liver Transplantation for Hepatoblastoma or Hepatocellular Carcinoma"],"prefix":"10.3390","volume":"11","author":[{"given":"Marek","family":"Stefanowicz","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0555-2229","authenticated-orcid":false,"given":"Piotr","family":"Kalici\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hor","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Broniszczak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Szymczak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Pankowska-Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Roszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"\u015awi\u0119szkowska","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Kami\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9624-9780","authenticated-orcid":false,"given":"Sylwia","family":"Szyma\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pathomorphology, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7183-7711","authenticated-orcid":false,"given":"Grzegorz","family":"Kowalewski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Organ Transplantation, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kakos, C.D., Ziogas, I.A., Demiri, C.D., Esagian, S.M., Economopoulos, K.P., Moris, D., Tsoulfas, G., and Alexopoulos, S.P. (2022). Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review. Cancers, 14.","DOI":"10.3390\/cancers14051294"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sindhi, R., Rohan, V., Bukowinski, A., Tadros, S., de Ville de Goyet, J., Rapkin, L., and Ranganathan, S. (2020). Liver Transplantation for Pediatric Liver Cancer. Cancers, 12.","DOI":"10.3390\/cancers12030720"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1200\/JCO.2014.60.2250","article-title":"Hepatocellular Carcinoma in Children: Does Modified Platinum- and Doxorubicin-Based Chemotherapy Increase Tumor Resectability and Change Outcome? Lessons Learned From the SIOPEL 2 and 3 Studies","volume":"34","author":"Murawski","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_4","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. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/lt.24994","article-title":"Survival of children after liver transplantation for hepatocellular carcinoma","volume":"24","author":"Baumann","year":"2018","journal-title":"Liver Transpl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1111\/ajt.16945","article-title":"Predictors of survival following liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma: Experience from the Society of Pediatric Liver Transplantation (SPLIT)","volume":"22","author":"Boster","year":"2022","journal-title":"Am. J. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e14047","DOI":"10.1111\/petr.14047","article-title":"Living donor liver transplantation for hepatic malignancies in children","volume":"25","author":"Pire","year":"2021","journal-title":"Pediatr. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1055\/s-0038-1668148","article-title":"Prognostic Factors for Liver Transplantation in Unresectable Hepatoblastoma","volume":"29","author":"Cano","year":"2019","journal-title":"Eur. J. Pediatr. Surg."},{"key":"ref_9","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. 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Blood Cancer"},{"key":"ref_16","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 Transpl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ejca.2018.10.013","article-title":"Microscopically positive resection margin after hepatoblastoma resection: What is the impact on prognosis? A Childhood Liver Tumours Strategy Group (SIOPEL) report","volume":"106","author":"Aronson","year":"2019","journal-title":"Eur. J. Cancer"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/2\/193\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:54:29Z","timestamp":1760104469000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/2\/193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,3]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["children11020193"],"URL":"https:\/\/doi.org\/10.3390\/children11020193","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,3]]}}}