Hepatocellular Carcinoma in a Child With Intestinal Failure–associated Liver Disease

Yeop, Intan; Ce, Taylor; Narula, Priya; Johnson, Lisa G.; Bowen, Chris V.; Gupte, Girish

doi:10.1097/mpg.0b013e31822cde6a

Cited by 9 publications

(4 citation statements)

References 9 publications

(9 reference statements)

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“…In addition to progressive biliary cirrhosis and portal hypertension, hepatocellular carcinoma has been reported as a rare complication in children with liver cirrhosis secondary to long-term PN. 5 …”

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confidence: 99%

Intestinal Microbiota, Lipids, and the Pathogenesis of Intestinal Failure–Associated Liver Disease

Lee

Sokol

2015

The Journal of Pediatrics

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confidence: 99%

Intestinal Microbiota, Lipids, and the Pathogenesis of Intestinal Failure–Associated Liver Disease

Lee

Sokol

2015

The Journal of Pediatrics

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“…normalize, 10,14 but histological liver fibrosis may persist or even progress. [15][16][17][18][19][20] The type and reversibility of histological liver injury and its risk factors during and after weaning off PN are insufficiently characterized. 4 Previous reports and our own clinical experience have pointed out that significant abnormalities in liver histology may persist and liver damage may, in some cases, continue to proceed, even after weaning off PN.…”

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confidence: 99%

Persistent abnormal liver fibrosis after weaning off parenteral nutrition in pediatric intestinal failure

et al. 2013

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The aim of this study was to evaluate the long-term effects of pediatric intestinal failure (IF) on liver histology. Altogether, 38 IF patients (median age: 7.2 years; range, 0.2-27) underwent liver biopsy, gastroscopy, abdominal ultrasound, and laboratory tests. Sixteen patients were on parenteral nutrition (PN) after 74 PN months (range, 2.5-204). Twentytwo had weaned off PN 8.8 years (range, 0.3-27) earlier, after 35 PN months (range,. Fifteen transplant donor livers served as controls. Abnormal liver histology was found in 94% of patients on PN and 77% of patients weaned off PN (P 5 0.370). During PN, liver histology weighted with cholestasis (38% of patients on PN versus 0% of patients weaned off PN; P 5 0.003) and portal inflammation (38% versus 9%; P 5 0.050) were found. Fibrosis (88% versus 64%; P 5 0. ; P 5 0.037) were significantly higher during than after weaning off PN. Esophageal varices were encountered in 1 patient after weaning off PN. Metavir stage was associated with small bowel length (r 5 20.486; P 5 0.002) and number of septic episodes (r 5 0.480; P 5 0.002). In a multivariate analysis, age-adjusted small bowel length (ß 5 20.533; P 5 0.001), portal inflammation (ß 5 0.291; P 5 0.030), and absence of an ileocecal valve (ß 5 0.267; P 5 0.048) were predictive for fibrosis stage. Conclusion: Despite resolution of cholestasis and portal inflammation, significant liver fibrosis and steatosis persist after weaning off PN. Extensive small intestinal resection was the major predictor for liver fibrosis stage. (HEPATOLOGY 2013;58:729-738)

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“…After screening titles and abstracts, 563 articles were retrieved for full-text evaluation. Ultimately, 67 non-overlapping studies [ 11 , 12 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ,…”

Section: Resultsmentioning

confidence: 99%

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review

Kakos¹,

Ziogas

Demiri

et al. 2022

Cancers

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Liver transplantation (LT) is the only potentially curative option for children with unresectable hepatocellular carcinoma (HCC). We performed a systematic review of the MEDLINE, Scopus, Cochrane Library, and Web of Science databases (end-of-search date: 31 July 2020). Our outcomes were overall survival (OS) and disease-free survival (DFS). We evaluated the effect of clinically relevant variables on outcomes using the Kaplan–Meier method and log-rank test. Sixty-seven studies reporting on 245 children undergoing LT for HCC were included. DFS data were available for 150 patients and the 1-, 3-, and 5-year DFS rates were 92.3%, 89.1%, and 84.5%, respectively. Sixty of the two hundred and thirty-eight patients (25.2%) died over a mean follow up of 46.8 ± 47.4 months. OS data were available for 222 patients and the 1-, 3-, and 5-year OS rates were 87.9%, 78.8%, and 74.3%, respectively. Although no difference was observed between children transplanted within vs. beyond Milan criteria (p = 0.15), superior OS was observed in children transplanted within vs. beyond UCSF criteria (p = 0.02). LT can yield favorable outcomes for pediatric HCC beyond Milan but not beyond UCSF criteria. Further research is required to determine appropriate LT selection criteria for pediatric HCC.

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Hepatocellular Carcinoma in a Child With Intestinal Failure–associated Liver Disease

Cited by 9 publications

References 9 publications

Intestinal Microbiota, Lipids, and the Pathogenesis of Intestinal Failure–Associated Liver Disease

Intestinal Microbiota, Lipids, and the Pathogenesis of Intestinal Failure–Associated Liver Disease

Persistent abnormal liver fibrosis after weaning off parenteral nutrition in pediatric intestinal failure

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review

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