Background: Hepatoblastoma is a rare malignancy but the most common primary hepatic malignancy in childhood. Pediatric liver transplantation (LT) offers the possibility to achieve a complete resection in otherwise unresectable tumors. Almost no data are available regarding specific surgical technique of LT in children with hepatoblastoma.
Methods: We analyzed all children with hepatoblastoma and LT between 2007 and 2012. Special regard was given to the surgical technique and long-term follow-up.
Results: Overall 7 children were transplanted with the diagnosis of hepatoblastoma (5 male, 2 female). Thereof, 4 children (median age was 11 months, range, 6-31 months) underwent "primary" LT for hepatoblastoma Pretreatment Extent of Disease III to IV. A 4-year-old boy received "salvage" LT for recurrent hepatoblastoma 2.5 years after successful liver resection. Another 15-year-old boy was transplanted as a prophylactic treatment after repeated liver resection for hepatoblastoma due to the high recurrence risk. A 14-year-old boy underwent LT due to complications following liver resection for hepatoblastoma during infancy. In all children, extensive en bloc hepatectomy was performed together with resection of the adjoining retroperitoneal tissue and regional lymphadenectomy. Actually, all children are alive without tumor recurrence median 7.1 years after LT (range, 5.7-10.7 years).
Conclusion: Our data show an excellent long-term outcome in selected children with hepatoblastoma undergoing standardized en bloc hepatectomy for "primary" and "rescue" LT with 100% overall and recurrence-free survival.
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http://dx.doi.org/10.1016/j.transproceed.2019.04.025 | DOI Listing |
Ann Surg Oncol
December 2024
Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Hépatiques et Digestives, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
Background: Total vascular exclusion (TVE) with liver hypothermic perfusion under venovenous bypass (VVB) is usually needed to perform hepatectomy with Inferior vena cava and hepatic veins resection-reconstruction. An alternative technique is represented by liver resection under intermittent pedicular clamping, IVC total clamping and VVB, without cold perfusion and liver outflow drainage through the VVB. PATIENTS AND METHODS: The patient is a 60-year-old woman with past medical history of right hepatectomy for leiomyosarcoma 14 years previously.
View Article and Find Full Text PDFAm J Surg
January 2025
Digestive Health Institute, AdventHealth Tampa, Tampa, FL, USA. Electronic address:
Ann Surg Oncol
October 2024
Abdominal Surgery and Transplantation Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Background: Surgery is the only curative treatment for retrohepatic inferior vena cava (r-IVC) leiomyosarcoma. Cavo-hepatic confluence invasion is a poor prognostic situation, requiring extreme liver surgery for selected patients to achieve R margins (a crucial prognostic factor). Ex situ liver resection and autotransplantation (ELRA), developed by Pichlmayr et al.
View Article and Find Full Text PDFJ Vis Exp
May 2024
Division of Vascular and Endovascular Surgery and the Center for Vascular Biology Research, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School; The Transplant Institute and the Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School;
Partial 2/3 hepatectomy in mice is used in research to study the liver's regenerative capacity and explore outcomes of liver resection in a number of disease models. In the classical partial 2/3 hepatectomy in mice, two of the five liver lobes, namely the left and median lobes representing approximately 66% of the liver mass, are resected en bloc with an expected postoperative survival of 100%. More aggressive partial hepatectomies are technically more challenging and hence, have seldom been used in mice.
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