Role of liver transplantation in the management of XXXX in the pediatric population.

@entity1 @entity632 @entity96 @entity5 @entity900 @entity74 @entity1891 @entity3851 @entity1487 @entity4177
@entity4177 ( @entity4177 ) is the most common primary @entity96 in @entity1 and accounts for two-thirds of all @entity96 in the pediatric population. For @entity1 with advanced @entity4177 (unresectable or unresponsive to chemotherapy), combined treatment with chemotherapy and liver transplantation is an excellent option. The etiology of @entity4177 is mostly obscure because of its extreme rarity although some @entity74 and very low birth weight have been associated with it. The prognosis for @entity1 with @entity4177 has significantly improved in the past three decades thanks to advancements in chemotherapy, surgical resection and postoperative care. In 2002 a surgical staging system called pretreatment extent of disease (PRETEXT) was designed to allow a universal, multidisciplinary approach to @entity1 with @entity4177 . Between one-third to two-thirds of @entity1 initially present with unresectable @entity5 or distant metastases, but up to 85% of these @entity5 become operable after neoadjuvant chemotherapy. @entity1 with PRETEXT categories 1, 2, and some 3 are referred for neoadjuvant chemotherapy followed by surgical resection with the @entity5 removal. Classic treatments regimens include a combination of @entity900 , @entity1487 , and @entity1891 or @entity900 and @entity632 . Liver transplantation is the only treatment option for unresectable @entity4177 . In 2010 the pediatric @entity3851 , a pediatric-specific scoring system that determines a @entity1 's ranking on the liver transplant list, began to award additional "exception" points for @entity1 with @entity4177 . We analyzed the Standard Transplant Analysis and Research dataset to assess the impact of changes in exception point criteria for @entity4177 on outcomes after liver transplantation at Texas @entity1 's Hospital in Houston, Texas. We found that @entity1 who were listed for transplantation with current @entity4177 exception criteria experienced a shorter waitlist time but survival was similar between the two eras.
