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- Title
Abdominal transplantation for unresectable tumors in children: the zooming out principle.
- Authors
Samuk, Inbal; Tekin, Akin; Tryphonopoulos, Panagiotis; Pinto, Ignacio; Garcia, Jennifer; Weppler, Debbie; Levi, David; Nishida, Seigo; Selvaggi, Gennaro; Ruiz, Phillip; Tzakis, Andreas; Vianna, Rodrigo; Pinto, Ignacio G; Levi, David M; Tzakis, Andreas G
- Abstract
<bold>Purpose: </bold>To present our experience in abdominal transplantations to manage unresectable abdominal neoplasms in children and to describe the role of extensive surgeries in such cases.<bold>Methods: </bold>This is a retrospective study of 22 abdominal transplantations in 21 patients for abdominal tumors over 16 years. Transplantation techniques included liver transplant (LT), multivisceral transplant (MVTx), and intestinal autotransplant (IA). Follow-up intervals ranged from 0.3 to 168 months (median 20 months).<bold>Results: </bold>LT alone was performed in 15 patients for primary malignant (11) and benign (4) liver tumors. Pathological classification included HB hepatoblastoma (6), HCC hepatocellular cancer (3), hepatic epithelioid hemangioendothelioma HEH (1), angiosarcoma (1), benign vascular tumors (3), and adenoma (1). IA was performed in four patients for lesions involving the root of the mesentery; tumors of the head of pancreas (3) and mesenteric hemangioma (1). MVTx was performed in 2 patients for malignancies; pancreaticoblastoma (1), recurrent hepatoblastoma (1), and in one patient as a rescue procedure after IA failure. Four of the eleven patients who underwent LT for malignant liver tumor had metastatic disease at presentation. Six of them died of recurrent neoplasm (3), transplant-related complications (2), and underlying disease (1). All LT patients who had benign tumors are alive with functioning grafts. All IA patients survived and are on an oral diet, with one patient requiring TPN supplementation. One of the three patients who underwent MVTx died of metastatic disease.<bold>Conclusions: </bold>Allo/auto transplantation for abdominal tumors is a valuable modality when conventional treatments fail or are not feasible.
- Subjects
LIVER transplantation; ABDOMINAL surgery; TRANSPLANTATION of organs, tissues, etc.; AUTOTRANSPLANTATION; ANGIOSARCOMA; INTESTINE transplantation; IMMUNOSUPPRESSIVE agents; ABDOMINAL tumors; AUTOGRAFTS; HUMAN body; GRAFT rejection; HOMOGRAFTS; LIVER tumors; MESENTERY; PANCREATIC tumors; PERITONEUM tumors; RETROSPECTIVE studies; DIGESTIVE organs; TUMORS
- Publication
Pediatric Surgery International, 2016, Vol 32, Issue 4, p337
- ISSN
0179-0358
- Publication type
journal article
- DOI
10.1007/s00383-015-3852-3