Abstract:
:Patients with failing Fontan physiology and liver cirrhosis are being considered for combined heart and liver transplantation. We performed a retrospective review of our experience with en bloc combined heart and liver transplantation in Fontan patients > 10 years old from 2006 to 18 per Institutional Review Board approval. Six females and 3 males (median age 20.7, range 14.2-41.3 years) underwent en bloc combined heart and liver transplantation. Indications for heart transplant included ventricular dysfunction, atrioventricular valve regurgitation, arrhythmia, and/or lymphatic abnormalities. Indication for liver transplant included portal hypertension and cirrhosis. Median Fontan/single ventricular end-diastolic pressure was 18/12 mm Hg, respectively. Median Model for End-Stage Liver Disease excluding International Normalized Ratio score was 10 (7-26), eight patients had a varices, ascites, splenomegaly, thrombocytopenia score of ≥ 2, and all patients had cirrhosis. Median cardiopulmonary bypass and donor ischemic times were 262 (178-307) and 287 (227-396) minutes, respectively. Median intensive care and hospital stay were 19 (5-96) and 29 (13-197) days, respectively. Survival was 100%, and rejection was 0% at 30 days and 1 year post-transplant. En bloc combined heart and liver transplantation is an acceptable treatment in the failing Fontan patient with liver cirrhosis.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Vaikunth SS,Concepcion W,Daugherty T,Fowler M,Lutchman G,Maeda K,Rosenthal DN,Teuteberg J,Woo YJ,Lui GKdoi
10.1111/ctr.13540subject
Has Abstractpub_date
2019-06-01 00:00:00pages
e13540issue
6eissn
0902-0063issn
1399-0012journal_volume
33pub_type
临床试验,杂志文章abstract:INTRODUCTION:The aim of this paper was to review the outcomes of cardiac transplantation with regards to short- and long-term survival, focusing particularly on patients who receive organs with long ischemic times and the resource utilization necessary to support such patients through their postoperative period. METHO...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00644.x
更新日期:2007-05-01 00:00:00
abstract::Kidney outcomes in early post-liver transplantation (LT) are crucial for long-term prognosis, but difficult to predict. Among 203 adult LT patients, we studied the value of plasma neutrophil gelatinase-associated lipocalin (NGAL) measured pre-LT for predicting acute kidney injury (AKI), kidney-replacement therapy with...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12394
更新日期:2014-08-01 00:00:00
abstract::The aim of this study was to identify indicators of outcome prior to transplantation in allogeneic hematopoietic stem cell transplantation (HCT). Clinical data of 106 patients with acute leukemia were retrospectively analyzed. We examined the role of pre-conditioning serum C-reactive protein (CRP) and ferritin levels,...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12028
更新日期:2012-09-01 00:00:00
abstract::Portal vein thrombosis (PVT), a common complication of end stage liver disease, is no longer considered a definite contraindication for liver transplantation (LTx). The clinical decision to perform an LTx in the case of PVT depends on the degree of PVT and the experience of the surgeon. Eversion thromboendovenectomy w...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2006.00560.x
更新日期:2006-09-01 00:00:00
abstract::Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parame...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12896
更新日期:2017-03-01 00:00:00
abstract::Although patients within a transplant program are awaiting or have received disease modifying or curative treatment, they are also facing advanced illness and the possibility of death. The involvement of specialized palliative care services for these patients may improve symptom management and facilitate advance care ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12838
更新日期:2016-12-01 00:00:00
abstract::We sought to determine the incidence, risk factors, and consequences of acute rejection (AR) after conversion from a calcineurin inhibitor (CNI) to a proliferation signal inhibitor (PSI) in maintenance heart transplantation. Relevant clinical data were retrospectively obtained for 284 long-term heart transplant recipi...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.12241
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The risk of de novo donor-specific antibody (dnDSA) development following BK viremia (BKV) or nephropathy (BKN) after kidney transplant remains unclear. We aimed to evaluate the relationships among dnDSA, BKV (BK blood PCR > 15 000 copies), BKN, antibody-mediated rejection (AMR), and allograft...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13194
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the hypothesis that intraoperative infusion of dexmedetomidine can exert a protective effect against hepatic ischemia-reperfusion injury (IRI) in adult living donor liver transplantation (LDLiver transplantation). PATIENTS AND METHODS:Forty recipients were allocated i...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/ctr.12713
更新日期:2016-04-01 00:00:00
abstract::In 1969, a study by Patel and Terasaki persuaded the renal transplant community that a pre-transplant cross-match should always be performed between donor and recipient to detect HLA antibodies and prevent hyperacute allograft rejection. Although the role of the cross-match among nonsensitized patients is controversia...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.16.s7.3.x
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Patients on organ transplant waiting lists continue to far exceed donor rates. We seek to understand the barriers preventing people in a Canadian city from donating organs for transplantation. METHODS:One thousand adults were surveyed assessing knowledge, personal involvement, and attitudes about organ dona...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01260.x
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Lung perfusions after single lung transplantation (SLT) have not been fully clarified in patients with interstitial lung disease (ILD). The present study aimed to investigate temporal changes in native lung perfusion and their associated clinical factors in patients with ILD who have undergone SLT. METHODS:...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12701
更新日期:2016-04-01 00:00:00
abstract::Liver cirrhosis is a recognized risk factor for intrahepatic cholangiocarcinoma (I-CCa). Small I-CCa nodules might be undiagnosed or misdiagnosed as hepatocellular carcinoma (HCC) in the context of liver cirrhosis. The aim of this study was to determine the prevalence and clinical impact of undetected I-CCa in liver e...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12108
更新日期:2013-05-01 00:00:00
abstract::Pancreas retransplantation has become more frequent and represents a technical challenge for surgeons. Knowledge of alternative surgical options could be useful in difficult cases. We present a case of brutal diabetes mellitus in a patient with severe vascular disease that underwent a third pancreas transplant. Diffic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01149.x
更新日期:2010-05-01 00:00:00
abstract::Cardiac allograft rejection and failure may require mechanical circulatory support as bridge-to-retransplantation. Prognosis in this patient group is poor and implantable ventricular assist devices have had limited success due to organ failure associated with the high dose immunosuppression required to treat ongoing r...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.12146
更新日期:2013-07-01 00:00:00
abstract::Mycophenolate mofetil (MMF) combined with conventional cyclosporine and steroids doses efficiently prevents acute rejection in kidney transplants. However, this regimen has been associated with an increased incidence of cytomegalovirus (CMV) disease and leukopenia, specially in patients receiving MMF at 3 g/d, suggest...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-06-01 00:00:00
abstract::Atherosclerosis is a chronic inflammatory process affecting mainly elastic and muscular arteries. Although small arteries and arterioles are usually spared, atherosclerosis can occur in these small vasculatures for a very short period. Here we report a case of atherosclerosis-like lesions that occurred in a transplant...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.16.s8.7.x
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder characterized by premature mortal cardiovascular complications. Liver transplantation (LT) is the only curative treatment option. In this study, the long-term clinical follow-up data of 8 patients who underwent LT with a diagnosis o...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13730
更新日期:2019-12-01 00:00:00
abstract::We report an adult liver transplant recipient with parvovirus B19 infection, presenting as chronic transfusion-dependent anemia ensuing 1 month post-transplantation. Both serum and bone marrow cells were positive for parvovirus B19 DNA detected by polymerase chain reaction. The bone marrow biopsy revealed erythroid hy...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Delayed graft function (DGF) remains a major barrier to improved outcomes after kidney transplantation. High-risk transplant recipients can be identified, but no definitive prediction model exists. Novel biomarkers to predict DGF in the first hours post-transplant, such as neutrophil gelatinase-associated lipocalin (N...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.12832
更新日期:2016-10-01 00:00:00
abstract::This multicenter, randomized trial aimed to compare the safety and efficacy of an early reduction in corticosteroid dose vs. long-term maintenance in Brazilian patients on an immunosuppressive regimen based on tacrolimus and mycophenolate mofetil (MMF). In the control arm, prednisone was progressively reduced from day...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-0012.2009.01185.x
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Ischemia-reperfusion injury impacts early liver graft function. Interleukin 6 (IL-6) as early as at reperfusion has shown to predict in-hospital complications, but its impact on vascular complications and long-term outcomes is not ascertained. METHODS:A retrospective study was conducted on all cons...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13357
更新日期:2018-09-01 00:00:00
abstract::Histopathologic diagnoses in transplantation can be improved with molecular testing. Preferably, molecular diagnostics should fit into standard-of-care workflows for transplant biopsies, that is, formalin-fixed paraffin-embedded (FFPE) processing. The NanoString(®) gene expression platform has recently been shown to w...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12689
更新日期:2016-03-01 00:00:00
abstract::To define the etiology of anemia post-renal transplantation, we assessed hematologic parameters and EPO levels in 38 anemic and 16 non-anemic control renal transplant recipients (RTRs) with varying degrees of allograft function at periods > 3 months post-transplantation. Significant differences between the two groups ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Stem cell-based therapy has received attention as a possible alternative to organ transplantation. The aim of this study was to assess the safety and efficacy of autologous transplantation of bone marrow (BM)-derived stromal cells in post-HCV liver cirrhosis patients. METHODOLOGY:10 × 10(6) of isolated huma...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12179
更新日期:2013-07-01 00:00:00
abstract::Temporary graft dysfunction with gas exchange abnormalities is a common finding during the postoperative course of a lung transplant and is often determined by the post-reimplantation syndrome. Supportive measures including oxygen by mask, inotropes, diuretics, and pulmonary vasodilators are usually effective in non-s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01050.x
更新日期:2009-09-01 00:00:00
abstract::Clinical outcomes are generally worse for black vs nonblack renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more intense-based, belatacept less intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival vs c...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/ctr.13225
更新日期:2018-04-01 00:00:00
abstract::This study evaluated the efficacy of primary endovascular stenting in cases of transplant renal artery stenosis (TRAS) from cadaver and non-heart-beating donor kidneys. Patients with TRAS (n = 13) from a single-centre transplant population (n = 476) were treated by primary percutaneous angioplasty and endovascular ste...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00499.x
更新日期:2006-05-01 00:00:00
abstract::Renal transplantation is presently the best treatment for end-stage renal disease, although considered contraindicated for elderly patients. However, more investigation is needed due to higher life expectancy rates of the general population and the increasing number of over 60-yr-old patients with chronic renal failur...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00734.x
更新日期:2007-11-01 00:00:00
abstract:INTRODUCTION:Thrombosis of the pancreas after transplantation is the most common cause of relaparotomy and resultant graft loss. There is currently no standard protocol consistently proven to prevent thrombosis following transplantation. Our objective was to determine whether our protocol of post-operative low-dose int...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12780
更新日期:2016-09-01 00:00:00