Mortality and morbidity after combined heart and liver transplantation in the failing Fontan: An updated dual center retrospective study.
Publication/Presentation Date
4-1-2024
Abstract
INTRODUCTION: As the adult Fontan population with Fontan associated liver disease continues to increase, more patients are being referred for transplantation, including combined heart and liver transplantation.
METHODS: We report updated mortality and morbidity outcomes after combined heart and liver transplant in a retrospective cohort series of 40 patients (age 14 to 49 years) with Fontan circulation across two centers from 2006-2022.
RESULTS: The 30-day, 1-year, 5-year and 10-year survival rate was 90%, 80%, 73% and 73% respectively. Sixty percent of patients met a composite comorbidity of needing either post-transplant mechanical circulatory support, renal replacement therapy or tracheostomy. Cardiopulmonary bypass time > 283 min (4.7 h) and meeting the composite comorbidity were associated with mortality by Kaplan Meier analysis.
CONCLUSION: Further study to mitigate early mortality and the above comorbidities as well as the high risk of bleeding and vasoplegia in this patient population is warranted.
Volume
38
Issue
4
First Page
15302
Last Page
15302
ISSN
1399-0012
Published In/Presented At
Vaikunth, S. S., Ortega-Legaspi, J. M., Conrad, D. R., Chen, S., Daugherty, T., Haeffele, C. L., Teuteberg, J., Mclean, R., MacArthur, J. W., Woo, Y. J., Maeda, K., Ma, M., Nasirov, T., Hoteit, M., Hilscher, M. B., Wald, J., Mandelbaum, T., Olthoff, K. M., Abt, P. L., Atluri, P., … Kim, Y. Y. (2024). Mortality and morbidity after combined heart and liver transplantation in the failing Fontan: An updated dual center retrospective study. Clinical transplantation, 38(4), e15302. https://doi.org/10.1111/ctr.15302
Disciplines
Medicine and Health Sciences
PubMedID
38567883
Department(s)
Department of Surgery
Document Type
Article