Transplant Trial Watch

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review.

Kakos, C. D., et al.

Cancers 2022; 14(5): 02.


Aims
This study aimed to summarise all available evidence on the clinicopathological characteristics and oncological outcomes following liver transplantation (LT) among pediatric hepatocellular carcinoma (HCC) patients.

Interventions
Electronic databases including MEDLINE, Scopus, Cochrane Library, and Web of Science were searched. Studies were screened and data were extracted by two independent reviewers.

Participants
67 studies were included in the review.

Outcomes
The main outcomes were overall survival, disease-free survival and posttransplant complications.

Follow-up
N/A

CET Conclusions
This is a well-written report of a well-conducted systematic review in paediatric liver transplantation. Multiple databases were searched, and studies and data were extracted by two reviewers in duplicate. Sixty-seven studies reporting 245 patients in total were included from many different countries worldwide, published between 1985 and 2020. Each included study may have had only a few patients, range 1-25, with most studies reporting 1-2 patients only. The authors provide a general comment about the quality of included studies, and it would have been better to see individual studies formally quality assessed and possibly stratified for quality or by era of treatment. At mean follow up of 38.6 months, tumour recurrence was reported in 16.2% of patients, most commonly in the lungs and liver. 5-year disease free survival was 84.5%. At mean follow up of 46.8 months, overall survival was 84.8%, with tumour recurrence being the most common cause and this fits with the expected rate of tumour recurrence. 5-year overall survival was 74.3%. Liver transplantation to treat HCC in children offers long-term survival, and grafts from live donors showed a significant improvement compared to deceased donor grafts.

Trial registration
reviewregistry1310

Funding source
No funding received