Transplant-Amenable Hepatocellular Carcinoma in a Fontan Patient

Abstract

The Fontan circulation alters a patient’s physiology and imparts long-term risks related to chronically elevated systemic venous pressure. An increasing number of patients with Fontan physiology are surviving into adulthood and are at risk of hepatic sequalae. The ideal timeline and method of hepatic surveillance in the Fontan population remains to be defined. In this case, the patient was diagnosed with hepatocellular carcinoma more than 20 years after undergoing the Fontan procedure and was a candidate for combined heart-liver transplant. That her disease progressed prior to organ availability supports the argument for hepatic surveillance in this population.

Hepatocellular carcinoma and the Fontan circulation: Clinical presentation and outcomes

“…This dataset has been extended by 20 published cases of patients with a Fontan circulation and a diagnosis of HCC found via PubMed search [5,[19][20][21][22][23][24][25][26][27][28][29][30].…”

Hepatocellular carcinoma after Fontan surgery: A systematic review

“…Twenty-six studies including 65 patients with biopsy-proven HCC were selected for our main analysis: one prospective cohort, 12 six retrospective cohorts 5,6,9,[22][23][24] , five retrospective case series, 7,25-28 and 14 case reports. 10,18,[29][30][31][32][33][34][35][36][37][38][39][40] Eleven reports were from North America, seven from Asia, six from Europe, one from Australia, one from Turkey, and one from both North America and Europe (see Table S1). Four were multicenter studies.…”