*Purpose: Undifferentiated Embryonal Cell Sarcoma (UESL) of the liver is the third most common malignant liver disease of childhood presenting as a rapidly enlarging intra-abdominal mass. This systematic review explores the practicality of liver transplantation, as a viable option in the treatment armamentarium for locally advanced Undifferentiated Embryonal Cell Sarcoma.

*Methods: A systematic review of the literature was performed using Medline and Embase, from inception of databases to Dec 31^st 2018. Keywords and MeSH headings used were embryonal sarcoma, mesenchymal sarcoma and liver transplant. Reviews and manuscripts with incomplete data were excluded.

*Results: 28 patients had orthotopic liver transplantation (OLT) as a curative treatment option. The median age at presentation was 8 and 27 years in the paediatric and adult population respectively with a similar male to female ratio. A majority of the patients presented with abdominal pain, palpable mass and a normal AFP. The median tumour size was 15 cm mainly affecting the right lobe (62%) of the liver. 82% of the patients underwent primary OLT and 5 patients had salvage OLT. One death (3.6%) was due to initial misdiagnosis and management for hepatoblastoma. Recurrence was noted in 7.1% of the population. The median followup period was 28.5 months. The documented survival rate post liver transplant for UESL was 96%.

*Conclusions: This abstract outline what we believe is the largest review series of undifferentiated embryonal cell sarcomas treated with liver transplantation Based on available data, and the very positive results therein, liver transplantation is a practical and justifiable use of a scarce resource as a treatment option for locally unresectable, undifferentiated embryonal cell sarcoma.

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