ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2014
Liver cirrhosis in Fontan patients does not affect 1-year post-heart transplant mortality or markers of liver function.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mortality Outcomes of Combined Heart and Liver Transplantation and Isolated Heart Transplantation Following Fontan Procedures: A Systematic Review and Meta-Analysis.Pediatric transplantation · 2025Pooled it
- Effect of liver abnormalities on mortality in Fontan patients: a systematic review and meta-analysis.BMC cardiovascular disorders · 2024Pooled it
- Inter-reader agreement and correlation of VAST, Fontan liver MRI score and MR elastography derived liver stiffness in children and young adults with Fontan-associated liver disease.Abdominal radiology (New York) · 2026Article
- Long-Term Care in Fontan Circulation: Surveillance and Management of Fontan-Associated Liver Disease and Protein-Losing Enteropathy.Current cardiology reports · 2026Review
- Platelet slope and long-term clinical outcomes in children and adults with Fontan-associated liver disease.Hepatology international · 2026Article
- Article
- Initial experience with combined heart-liver transplantation in the Netherlands: Exploring the boundaries of isolated and combined transplantation.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025Review
- "Fontan Conduit Stent-Angioplasty and Progression of Fontan-Associated Liver Disease".Pediatric cardiology · 2025Article
- Rejection in the setting of combined Heart and Liver Transplantation.International journal of cardiology. Congenital heart disease · 2024Article
- Poor correlation of 2D shear wave elastography and transient elastography in Fontan-associated liver disease: A head-to-head comparison.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- [Fontan-associated liver disease current status and transplantation consideration].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Transient liver elastography in the follow-up of Fontan patients: results of a nation wide survey in Germany.Frontiers in pediatrics · 2023Article
- Fontan-associated liver disease: Diagnosis, surveillance, and management.Frontiers in pediatrics · 2023Review
- Mechanical support for the failing single ventricle after Fontan.JTCVS techniques · 2022Article
- Management of circulatory failure after Fontan surgery.Frontiers in pediatrics · 2022Review
- Functional hepatic deterioration determined byFrontiers in cardiovascular medicine · 2022Article
- Failures of the Fontan System in Univentricular Hearts and Mortality Risk in Heart Transplantation: A Systematic Review and Meta-Analysis.Life (Basel, Switzerland) · 2021Review
- From Other Journals: A Review of Recent Articles by Our Editorial Team.Pediatric cardiology · 2021Article
- Comparison of combined heart‒liver vs heart-only transplantation in pediatric and young adult Fontan recipients.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2021Article
- From congestive hepatopathy to hepatocellular carcinoma, how can we improve patient management?JHEP reports : innovation in hepatology · 2021Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundLiver 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.
methodsWe 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.
resultsCT imaging in 32 Fontan patients evaluated for HT revealed 20 (63%) with evidence of liver disease, including 13 (41%) with cirrhosis. Twenty underwent HT, including 5 non-cirrhotic and 7 cirrhosis patients. Characteristics at listing between normal or non-cirrhotic (n = 13) and cirrhosis (n = 7) groups were similar, except cirrhosis patients were older (median 17.6 vs 9.6 years, p = 0.002) and further from Fontan (median 180 vs 50 months, p < 0.05). Serial liver evaluation was similar, including aspartate aminotransferase, alanine aminotransferase, bilirubin, albumin, and tacrolimus dose at 1, 3, 6, 9, and 12 months. Overall patient survival was 80% at 1 year, with no difference between cirrhosis and non-cirrhosis patients (86% vs 77%, p = 0.681). Liver biopsies were performed in 7 patients before HT, and all specimens showed architectural changes with bridging fibrosis.
conclusionsMost patients evaluated for HT had abnormal liver findings by CT, with cirrhosis in 41%. One-year mortality and serial liver evaluation were similar between groups after HT. Liver cirrhosis identified by CT imaging may not be an absolute contraindication to HT alone in this population.
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