Abstract:Background
Liver cirrhosis is recognized with long-term follow-up of patients
after the Fontan procedure. The effect of liver cirrhosis on the use of
heart transplant (HT) and on post-HT outcomes is unknown.
Methods
We reviewed Fontan patients evaluated for HT from 2004 to 2012 with
hepatic computed tomography (CT) imaging, classified as normal,
non-cirrhotic changes, or cirrhosis. The primary outcome was 1-year
all-cause mortality, and the secondary outcome was differences in serial
post-HT liver evaluation… Show more
“…Another recent study found no association between hepatic imaging and post-transplant outcomes in Fontan patients. 30 Therefore, we recommend considering histopathologic findings as one part of the greater picture when evaluating subjects for transplant.…”
“…Another recent study found no association between hepatic imaging and post-transplant outcomes in Fontan patients. 30 Therefore, we recommend considering histopathologic findings as one part of the greater picture when evaluating subjects for transplant.…”
“…In multivariate analysis, only the time since initial Fontan procedure was associated with hepatic complications. Importantly, Simpson et al 151 found in a small study of Fontan patients (mean age, 13 years) that computed tomography evidence of liver cirrhosis did not predict 1-year mortality after HTx. They did not systematically assess MELD scores, histology, or HVPG.…”
Section: Systemic Venous Anomalies In Patients With Situs Inversus Ormentioning
“…100,101 The impacts of portal fibrosis and cirrhosis on outcomes after transplantation are under investigation, with a few patients undergoing heart and liver transplantation when advanced cirrhosis is present. [102][103][104] The type of congenital heart disease also affects survival after transplantation. Patients who have undergone the Fontan procedure have a higher posttransplantation mortality than patients with other types of congenital heart disease, with one series reporting a hazard ratio of 8 for early mortality.…”
Section: Risk Factors For Mortality Unique To Patients With Congenitamentioning
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