Short-term outcomes of en bloc combined heart and liver transplantation in the failing Fontan.

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 Transplant

journal_title

Clinical transplantation

authors

Vaikunth SS,Concepcion W,Daugherty T,Fowler M,Lutchman G,Maeda K,Rosenthal DN,Teuteberg J,Woo YJ,Lui GK

doi

10.1111/ctr.13540

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

e13540

issue

6

eissn

0902-0063

issn

1399-0012

journal_volume

33

pub_type

临床试验,杂志文章
  • Prolonged cardiac allograft ischemic time--no impact on long-term survival but at what cost?

    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

    authors: Marasco SF,Esmore DS,Richardson M,Bailey M,Negri J,Rowland M,Kaye D,Bergin PJ

    更新日期:2007-05-01 00:00:00

  • Neutrophil gelatinase-associated lipocalin associated with irreversibility of pre-liver transplant kidney dysfunction.

    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

    authors: Aberg F,Lempinen M,Hollmén M,Nordin A,Mäkisalo H,Isoniemi H

    更新日期:2014-08-01 00:00:00

  • Prognostic role of pre-transplantation serum C-reactive protein levels in patients with acute leukemia undergoing myeloablative allogeneic stem cell transplantation.

    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

    authors: Akı ŞZ,Suyanı E,Bildacı Y,Çakar MK,Baysal NA,Sucak GT

    更新日期:2012-09-01 00:00:00

  • Surgical strategies for liver transplantation in the case of portal vein thrombosis--current role of cavoportal hemitransposition and renoportal anastomosis.

    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

    authors: Paskonis M,Jurgaitis J,Mehrabi A,Kashfi A,Fonouni H,Strupas K,Büchler MW,Kraus TW

    更新日期:2006-09-01 00:00:00

  • Evolution of body weight parameters up to 3 years after solid organ transplantation: The prospective Swiss Transplant Cohort Study.

    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

    authors: Beckmann S,Nikolic N,Denhaerynck K,Binet I,Koller M,Boely E,De Geest S,Psychosocial Interest Group, Swiss Transplant Cohort Study.

    更新日期:2017-03-01 00:00:00

  • The Transplant Palliative Care Clinic: An early palliative care model for patients in a transplant program.

    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

    authors: Wentlandt K,Dall'Osto A,Freeman N,Le LW,Kaya E,Ross H,Singer LG,Abbey S,Clarke H,Zimmermann C

    更新日期:2016-12-01 00:00:00

  • Rejection after conversion to a proliferation signal inhibitor in chronic heart transplantation.

    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

    authors: González-Vílchez F,Vázquez de Prada JA,Paniagua MJ,Almenar L,Mirabet S,Gómez-Bueno M,Díaz-Molina B,Arizón JM,Delgado J,Pérez-Villa F,Crespo-Leiro MG,Martínez-Dolz L,Roig E,Segovia J,Lambert JL,Lopez-Granados A,Escribano P

    更新日期:2013-11-01 00:00:00

  • De novo donor-specific antibody following BK nephropathy: The incidence and association with antibody-mediated rejection.

    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

    authors: Cheungpasitporn W,Kremers WK,Lorenz E,Amer H,Cosio FG,Stegall MD,Gandhi MJ,Schinstock CA

    更新日期:2018-03-01 00:00:00

  • Effect of dexmedetomidine on hepatic ischemia-reperfusion injury in the setting of adult living donor liver transplantation.

    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

    authors: Fayed NA,Sayed EI,Saleh SM,Ehsan NA,Elfert AY

    更新日期:2016-04-01 00:00:00

  • Conundrums with FlowPRA beads.

    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

    authors: Gebel HM,Harris SB,Zibari G,Bray RA

    更新日期:2002-01-01 00:00:00

  • Attitudes and opinions on organ donation: an opportunity to educate in a Canadian city.

    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

    authors: Lee E,Midodizi W,Gourishankar S

    更新日期:2010-11-01 00:00:00

  • Serial perfusion in native lungs in patients with idiopathic pulmonary fibrosis and other interstitial lung diseases after single lung transplantation.

    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

    authors: Sokai A,Handa T,Chen F,Tanizawa K,Aoyama A,Kubo T,Ikezoe K,Nakatsuka Y,Oguma T,Hirai T,Nagai S,Chin K,Date H,Mishima M

    更新日期:2016-04-01 00:00:00

  • Unrecognized intrahepatic cholangiocarcinoma: an analysis of 993 adult cirrhotic liver explants.

    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

    authors: Vallin M,Sturm N,Lamblin G,Guillaud O,Hilleret MN,Hervieu V,Joubert J,Abergel A,Leroy V,Boillot O,Dumortier J,Scoazec JY

    更新日期:2013-05-01 00:00:00

  • Orthotopic placement of a segmental pancreas graft for transplant: a case report.

    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

    authors: Garcia-Roca R,Humar A,Sturdevant M,Kobayashi T,Dunn T,Kandaswamy R,Sutherland D

    更新日期:2010-05-01 00:00:00

  • Role of total artificial heart in the management of heart transplant rejection and retransplantation: case report and review.

    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

    authors: Kalya A,Jaroszewski D,Pajaro O,Scott R,Gopalan R,Kasper D,Arabia F

    更新日期:2013-07-01 00:00:00

  • Incidence of leukopenia and cytomegalovirus disease in kidney transplants treated with mycophenolate mofetil combined with low cyclosporine and steroid doses.

    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:

    authors: Moreso F,Serón D,Morales JM,Cruzado JM,Gil-Vernet S,Pérez JL,Fulladosa X,Andrés A,Grinyó JM

    更新日期:1998-06-01 00:00:00

  • Accelerated atherosclerosis with apolipoprotein(a) and oxidized low-density lipoprotein deposition in acute rejection of transplanted kidney: analogous to atherosclerosis.

    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

    authors: Shimoyamada H,Fan J,Watanabe T,Nagata M

    更新日期:2002-01-01 00:00:00

  • The curative treatment of familial hypercholesterolemia: Liver transplantation.

    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

    authors: Gulsoy Kirnap N,Kirnap M,Bascil Tutuncu N,Moray G,Haberal M

    更新日期:2019-12-01 00:00:00

  • Parvovirus B19 infection in a liver transplant recipient: case report and review in organ transplant recipients.

    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:

    authors: Chang FY,Singh N,Gayowski T,Marino IR

    更新日期:1996-06-01 00:00:00

  • Prediction, prevention, and management of delayed graft function: where are we now?

    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

    authors: Nashan B,Abbud-Filho M,Citterio F

    更新日期:2016-10-01 00:00:00

  • Randomized trial of early corticosteroid reduction vs. regular-dose corticosteroid maintenance in combination with tacrolimus and mycophenolate mofetil in living donor kidney transplant recipients: the Brazilian CORRETA trial.

    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

    authors: Garcia VD,Carvalho DB,Gonçalves RT,Cavalcanti RL,Campos HH,Abbud-Filho M,Lobao-Neto AA

    更新日期:2010-07-01 00:00:00

  • Interleukin 6 at reperfusion: A potent predictor of hepatic and extrahepatic early complications after liver transplantation.

    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

    authors: Faitot F,Besch C,Lebas B,Addeo P,Ellero B,Woehl-Jaegle ML,Namer IJ,Bachellier P,Freys G

    更新日期:2018-09-01 00:00:00

  • Multiplexed color-coded probe-based gene expression assessment for clinical molecular diagnostics in formalin-fixed paraffin-embedded human renal allograft tissue.

    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

    authors: Adam B,Afzali B,Dominy KM,Chapman E,Gill R,Hidalgo LG,Roufosse C,Sis B,Mengel M

    更新日期:2016-03-01 00:00:00

  • Anemia following renal transplantation: erythropoietin response and iron deficiency.

    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:

    authors: Miles AM,Markell MS,Daskalakis P,Sumrani NB,Hong J,Sommer BG,Friedman EA

    更新日期:1997-08-01 00:00:00

  • Short-term evaluation of autologous transplantation of bone marrow-derived mesenchymal stem cells in patients with cirrhosis: Egyptian study.

    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

    authors: Amin MA,Sabry D,Rashed LA,Aref WM,el-Ghobary MA,Farhan MS,Fouad HA,Youssef YA

    更新日期:2013-07-01 00:00:00

  • Non-invasive ventilation in prone position for refractory hypoxemia after bilateral lung transplantation.

    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

    authors: Feltracco P,Serra E,Barbieri S,Persona P,Rea F,Loy M,Ori C

    更新日期:2009-09-01 00:00:00

  • Outcomes at 7 years post-transplant in black vs nonblack kidney transplant recipients administered belatacept or cyclosporine in BENEFIT and BENEFIT-EXT.

    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

    authors: Florman S,Vincenti F,Durrbach A,Abouljoud M,Bresnahan B,Garcia VD,Mulloy L,Rice K,Rostaing L,Zayas C,Calderon K,Meier-Kriesche U,Polinsky M,Yang L,Medina Pestana J,Larsen CP

    更新日期:2018-04-01 00:00:00

  • Primary endoluminal stenting of transplant renal artery stenosis from cadaver and non-heart-beating donor kidneys.

    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

    authors: Ridgway D,White SA,Nixon M,Carr S,Blanchard K,Nicholson ML

    更新日期:2006-05-01 00:00:00

  • Renal transplantation outcomes: a comparative analysis between elderly and younger recipients.

    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

    authors: Mendonça HM,Dos Reis MA,de Castro de Cintra Sesso R,Câmara NO,Pacheco-Silva A

    更新日期:2007-11-01 00:00:00

  • Heparin infusion in simultaneous pancreas and kidney transplantation reduces graft thrombosis and improves graft survival.

    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

    authors: Aboalsamh G,Anderson P,Al-Abbassi A,McAlister V,Luke PP,Sener A

    更新日期:2016-09-01 00:00:00