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Single-center outcomes of combined heart and liver transplantation in the failing Fontan
Single-center outcomes of combined heart and liver transplantation in the failing Fontan
- Source :
- Clinical Transplantation. 31:e12892
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Long-term outcomes of the Fontan operation include Fontan failure and liver disease. Combined heart-liver transplantation (CHLT) is an option for select patients although limited data exist on this strategy. A retrospective review of Fontan patients 18 years or older referred for cardiac transplant evaluation between 2000 and 2013 at the Hospital of the University of Pennsylvania was performed. All patients were considered for potential CHLT. Clinical variables such as demographics, perioperative factors, and short-term outcomes were reviewed. Of 17 referrals for cardiac transplantation, seven Fontan patients underwent CHLT. All patients who underwent CHLT had either advanced fibrosis or cirrhosis on liver biopsy. There were no perioperative deaths. The most common postoperative morbidity was acute kidney injury. Short-term complications include one episode of acute liver rejection but no cardiac rejection greater than 1R. CHLT is an acceptable therapeutic option for patients with failing Fontan physiology who exhibit concomitant advanced liver fibrosis. However, optimal patient selection is currently undefined, and long-term outcomes are not known.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Cirrhosis
Heart Diseases
medicine.medical_treatment
030204 cardiovascular system & hematology
030230 surgery
Liver transplantation
Fontan Procedure
Single Center
Young Adult
03 medical and health sciences
Liver disease
Postoperative Complications
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Retrospective Studies
Transplantation
medicine.diagnostic_test
business.industry
Liver Diseases
Graft Survival
Acute kidney injury
Perioperative
Prognosis
medicine.disease
Liver Transplantation
Surgery
surgical procedures, operative
Liver biopsy
cardiovascular system
Cardiology
Heart Transplantation
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 09020063
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Clinical Transplantation
- Accession number :
- edsair.doi.dedup.....277940188e4f252ecaa3323735407a58
- Full Text :
- https://doi.org/10.1111/ctr.12892