Liver transplantation for biliary atresia associated with malignant hepatic tumors

The authors report 3 cases of liver transplantations in children between 4 and 10 years of age, complicated with malignant hepatic tumors after biliar y atresia. The preoperative abdominal computed tomography (CT) scans of all 3 cases showed hepatic masses, The serum alpha-fetoprotein levels were ele vated highly in 2 cases. After living-related liver transplantation (LRLT), the pathologic findings of the masses in the resected livers showed hepato cellular carcinoma in 2 cases and hepatoblastoma in the other, All cases we re associated with biliary cirrhosis. The stage of the liver tumor in the 3 cases using the TNM system was IVA (T4, N0, M0), II (T2, N0, M0) and IVA ( T4, N0, M0). Chemotherapy was used in all cases after liver transplantation , and all patients survived with no recurrence. The results suggest that ev en though malignant liver tumors rarely are complicated with biliary atresi a in childhood, one should be alert to the occurrence of hepatic malignancy and perform routine screening of alpha-fetoprotein levels, abdominal CT sc ans, and magnetic resonance imagings, J Pediatr Surg 36:436-439. Copyright (C) 2007 by W.B. Saunders Company.