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Effects of an early referral system on liver transplantation for hepatoblastoma at Texas Children's Hospital
- Source :
- Pediatric Transplantation. 20:515-522
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- The purposes of this study were to analyze the effects of an ERS on time to transplantation and to describe our center's experience with OLT for HB. Patients who received OLT for HB between 2000 and 2013 were included. Patient and allograft characteristics, chemotherapy regimens, and prior surgical therapies were examined. The interval between diagnosis and OLT prior to and following the institution of an ERS for transplant was compared. Survival and tumor recurrence were analyzed. Nineteen patients received OLT for HB (mean age 33 months). All children received grafts from deceased donors. Two patients underwent prior resections. Tumor recurred in four patients (21.1%). Both patients who received salvage transplants experienced post-OLT recurrence. Three of the four recurrences occurred in spite of adjuvant chemotherapy. There were three deaths: two from metastatic disease. One- and five-yr survivals were 86.1% and 73.8%. After the institution of the ERS, the mean interval between tissue diagnosis and OLT was significantly reduced. Our series of 19 patients demonstrates a 21% recurrence of HB following OLT despite chemotherapy. Five-yr survival reached 73.8%. A system of early referral can effectively reduce times between diagnosis and transplant.
- Subjects :
- Hepatoblastoma
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Antineoplastic Agents
Liver transplantation
Health Services Accessibility
03 medical and health sciences
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Child
Referral and Consultation
Neoadjuvant therapy
Transplantation
Chemotherapy
business.industry
Liver Neoplasms
Infant
Mean age
Hospitals, Pediatric
medicine.disease
Texas
Neoadjuvant Therapy
Liver Transplantation
Surgery
Tumor recurrence
Treatment Outcome
surgical procedures, operative
Chemotherapy, Adjuvant
Child, Preschool
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Female
030211 gastroenterology & hepatology
Neoplasm Recurrence, Local
business
Follow-Up Studies
Early referral
Subjects
Details
- ISSN :
- 13973142
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Pediatric Transplantation
- Accession number :
- edsair.doi.dedup.....662024a1613d573aa9bbda1ad1d745a1