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Clinical Outcomes of Adult Fontan-Associated Liver Disease and Combined Heart-Liver Transplantation by Matthew J. Lewis; Leigh C. Reardon; Jamil Aboulhosn; Christiane Haeffele; Sharon Chen; Yuli Kim; Stephanie Fuller; Lisa Forbess; Laith Alshawabkeh; Marcus A. Urey; Wendy M. Book; Fred Rodriguez; Jonathan N. Menachem; Daniel E. Clark; Anne Marie Valente; Matthew Carazo; Alexander Egbe; Heidi M. Connolly; Eric V. Krieger; Jilian Angiulo; Ari Cedars; Jong Ko; Roni M. Jacobsen; Michael G. Earing; Jonathan W. Cramer; Peter Ermis; Christopher Broda; Natalia Nugaeva; Heather Ross; Jordan D. Awerbach; Richard A. Krasuski; Marlon Rosenbaum is a Medicine article available to read on EtoBox.
What is Clinical Outcomes of Adult Fontan-Associated Liver Disease and Combined Heart-Liver Transplantation about?
Background The impact of Fontan-associated liver disease (FALD) on post-transplant mortality and indications for combined heart-liver transplant (CHLT) in adult Fontan patients remains unknown. Objectives The purpose of this study was to assess the impact of FALD on post-transplant outcomes and compare HT vs CHLT in adult Fontan patients. Methods We performed a retrospective-cohort study of adult Fontan patients who underwent HT or CHLT across 15 centers. Inclusion criteria were as follows: 1) Fontan; 2) HT/CHLT referral; and 3) age ≥16 years at referral. Pretransplant FALD score was calculated using the following: 1) cirrhosis; 2) varices; 3) splenomegaly; or 4) ≥2 paracenteses. Results A total of 131 patients (91 HT and 40 CHLT) were included. CHLT recipients were more likely to be older (P = 0.016), have a lower hemoglobin (P = 0.025), require ≥2 diuretic agents pretransplant (P = 0.051), or be transplanted in more recent decades (P = 0.001). Postmatching, CHLT demonstrated a trend toward improved survival at 1 year (93% vs 74%; P = 0.097) and improved survival at 5 years (86% vs 52%; P = 0.041) compared with HT alone. In patients with a FALD score ≥2, CHLT was associated with i
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- Author
- Matthew J. Lewis; Leigh C. Reardon; Jamil Aboulhosn; Christiane Haeffele; Sharon Chen; Yuli Kim; Stephanie Fuller; Lisa Forbess; Laith Alshawabkeh; Marcus A. Urey; Wendy M. Book; Fred Rodriguez; Jonathan N. Menachem; Daniel E. Clark; Anne Marie Valente; Matthew Carazo; Alexander Egbe; Heidi M. Connolly; Eric V. Krieger; Jilian Angiulo; Ari Cedars; Jong Ko; Roni M. Jacobsen; Michael G. Earing; Jonathan W. Cramer; Peter Ermis; Christopher Broda; Natalia Nugaeva; Heather Ross; Jordan D. Awerbach; Richard A. Krasuski; Marlon Rosenbaum
- Publisher
- Elsevier BV
- Published
- 2023
- Language
- EN
- Field
- Medicine (Health Sciences)