Single-center outcomes of combined heart and liver transplantation in the failing Fontan

Benjamin A. D'Souza, Stephanie Fuller, Lacey P. Gleason, Nicole Hornsby, Joyce Wald, Karen Krok, Abraham Shaked, Lee R. Goldberg, Alberto Pochettino, Kim M. Olthoff, Yuli Y. Kim

Research output: Contribution to journalArticle

13 Citations (Scopus)

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.

Original languageEnglish (US)
Article numbere12892
JournalClinical Transplantation
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Heart Transplantation
Liver Transplantation
Liver Cirrhosis
Fontan Procedure
Acute Kidney Injury
Patient Selection
Liver Diseases
Fibrosis
Referral and Consultation
Demography
Morbidity
Transplants
Biopsy
Liver

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

D'Souza, B. A., Fuller, S., Gleason, L. P., Hornsby, N., Wald, J., Krok, K., ... Kim, Y. Y. (2017). Single-center outcomes of combined heart and liver transplantation in the failing Fontan. Clinical Transplantation, 31(3), [e12892]. https://doi.org/10.1111/ctr.12892
D'Souza, Benjamin A. ; Fuller, Stephanie ; Gleason, Lacey P. ; Hornsby, Nicole ; Wald, Joyce ; Krok, Karen ; Shaked, Abraham ; Goldberg, Lee R. ; Pochettino, Alberto ; Olthoff, Kim M. ; Kim, Yuli Y. / Single-center outcomes of combined heart and liver transplantation in the failing Fontan. In: Clinical Transplantation. 2017 ; Vol. 31, No. 3.
@article{2bf0720980654208b42970b2168bd585,
title = "Single-center outcomes of combined heart and liver transplantation in the failing Fontan",
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.",
author = "D'Souza, {Benjamin A.} and Stephanie Fuller and Gleason, {Lacey P.} and Nicole Hornsby and Joyce Wald and Karen Krok and Abraham Shaked and Goldberg, {Lee R.} and Alberto Pochettino and Olthoff, {Kim M.} and Kim, {Yuli Y.}",
year = "2017",
month = "3",
day = "1",
doi = "10.1111/ctr.12892",
language = "English (US)",
volume = "31",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "3",

}

D'Souza, BA, Fuller, S, Gleason, LP, Hornsby, N, Wald, J, Krok, K, Shaked, A, Goldberg, LR, Pochettino, A, Olthoff, KM & Kim, YY 2017, 'Single-center outcomes of combined heart and liver transplantation in the failing Fontan', Clinical Transplantation, vol. 31, no. 3, e12892. https://doi.org/10.1111/ctr.12892

Single-center outcomes of combined heart and liver transplantation in the failing Fontan. / D'Souza, Benjamin A.; Fuller, Stephanie; Gleason, Lacey P.; Hornsby, Nicole; Wald, Joyce; Krok, Karen; Shaked, Abraham; Goldberg, Lee R.; Pochettino, Alberto; Olthoff, Kim M.; Kim, Yuli Y.

In: Clinical Transplantation, Vol. 31, No. 3, e12892, 01.03.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Single-center outcomes of combined heart and liver transplantation in the failing Fontan

AU - D'Souza, Benjamin A.

AU - Fuller, Stephanie

AU - Gleason, Lacey P.

AU - Hornsby, Nicole

AU - Wald, Joyce

AU - Krok, Karen

AU - Shaked, Abraham

AU - Goldberg, Lee R.

AU - Pochettino, Alberto

AU - Olthoff, Kim M.

AU - Kim, Yuli Y.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85012882823&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85012882823&partnerID=8YFLogxK

U2 - 10.1111/ctr.12892

DO - 10.1111/ctr.12892

M3 - Article

C2 - 27988989

AN - SCOPUS:85012882823

VL - 31

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 3

M1 - e12892

ER -