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Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma.

Publication ,  Journal Article
Ezekian, B; Mulvihill, MS; Schroder, PM; Gilmore, BF; Leraas, HJ; Gulack, BC; Jane Commander, S; Mavis, AM; Kreissman, SG; Knechtle, SJ ...
Published in: Pediatr Transplant
December 2018

PURPOSE: Improvement in outcomes of LT for pediatric HB and HCC has been reported in small series. We analyzed national outcomes and changes in donor, recipient, and perioperative factors over time that may contribute to survival differences. METHODS: The UNOS database was queried for patients age <21 years that underwent LT for a primary diagnosis of HB or HCC (1987-2017). Subjects were divided into historic (transplant before 2010) and contemporary (transplant after 2010) cohorts. Baseline characteristics were compiled and examined. Survival was estimated using the Kaplan-Meier method and compared using the log-rank test. RESULTS: In total, 599 children with HB received LT (320 historic vs 279 contemporary). Concurrently, 141 children with HCC received LT (92 historic vs 49 contemporary). For both tumors, waitlist time decreased (HB 56.2 days historic vs 33.2 days contemporary, P = 0.017; HCC 189.3 days historic vs 71.7 days contemporary, P = 0.012). In the historic cohorts, patients with HB had a 1-year and 5-year OS of 84.6% and 75.1%, respectively. Survival for HCC was 84.4% and 59.9%, respectively. Outcomes improved in the contemporary era to 89.1% and 82.6% for HB, and 94.7% and 80.8% for HCC, respectively (both log-rank test P < 0.0001). CONCLUSION: Outcomes of LT have improved significantly, with contemporary survival now equivalent between these tumors and exceeding 80% 5-year OS. Future studies are needed to explore whether offering LT in patients that are resectable is justifiable.

Duke Scholars

Published In

Pediatr Transplant

DOI

EISSN

1399-3046

Publication Date

December 2018

Volume

22

Issue

8

Start / End Page

e13305

Location

Denmark

Related Subject Headings

  • Waiting Lists
  • United States
  • Treatment Outcome
  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Registries
  • Male
  • Living Donors
  • Liver Transplantation
 

Citation

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MLA
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Ezekian, B., Mulvihill, M. S., Schroder, P. M., Gilmore, B. F., Leraas, H. J., Gulack, B. C., … Barbas, A. S. (2018). Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma. Pediatr Transplant, 22(8), e13305. https://doi.org/10.1111/petr.13305
Ezekian, Brian, Michael S. Mulvihill, Paul M. Schroder, Brian F. Gilmore, Harold J. Leraas, Brian C. Gulack, Sarah Jane Commander, et al. “Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma.Pediatr Transplant 22, no. 8 (December 2018): e13305. https://doi.org/10.1111/petr.13305.
Ezekian B, Mulvihill MS, Schroder PM, Gilmore BF, Leraas HJ, Gulack BC, et al. Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma. Pediatr Transplant. 2018 Dec;22(8):e13305.
Ezekian, Brian, et al. “Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma.Pediatr Transplant, vol. 22, no. 8, Dec. 2018, p. e13305. Pubmed, doi:10.1111/petr.13305.
Ezekian B, Mulvihill MS, Schroder PM, Gilmore BF, Leraas HJ, Gulack BC, Jane Commander S, Mavis AM, Kreissman SG, Knechtle SJ, Tracy ET, Barbas AS. Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma. Pediatr Transplant. 2018 Dec;22(8):e13305.
Journal cover image

Published In

Pediatr Transplant

DOI

EISSN

1399-3046

Publication Date

December 2018

Volume

22

Issue

8

Start / End Page

e13305

Location

Denmark

Related Subject Headings

  • Waiting Lists
  • United States
  • Treatment Outcome
  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Registries
  • Male
  • Living Donors
  • Liver Transplantation