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Short-term outcomes of en bloc combined heart and liver transplantation in the failing Fontan.
Vaikunth, Sumeet S; Concepcion, Waldo; Daugherty, Tami; Fowler, Michael; Lutchman, Glen; Maeda, Katsuhide; Rosenthal, David N; Teuteberg, Jeffrey; Woo, Y Joseph; Lui, George K.
Afiliação
  • Vaikunth SS; Department of Pediatrics, Division of Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California.
  • Concepcion W; Department of Transplant Surgery, Stanford University School of Medicine, Palo Alto, California.
  • Daugherty T; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California.
  • Fowler M; Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California.
  • Lutchman G; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California.
  • Maeda K; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California.
  • Rosenthal DN; Department of Pediatrics, Division of Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California.
  • Teuteberg J; Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California.
  • Woo YJ; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California.
  • Lui GK; Department of Pediatrics, Division of Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California.
Clin Transplant ; 33(6): e13540, 2019 06.
Article em En | MEDLINE | ID: mdl-30891780
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Transplante de Coração / Transplante de Fígado / Técnica de Fontan / Cirrose Hepática Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Transplante de Coração / Transplante de Fígado / Técnica de Fontan / Cirrose Hepática Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Ano de publicação: 2019 Tipo de documento: Article