ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2016
Improved survival after heart transplant for failed Fontan patients with preserved ventricular function.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Fontan Failure: Current State of the Art in Mechanical Circulatory Support and Transplantation.Children (Basel, Switzerland) · 2026Review
- Benefits of Coiling Aorto-Pulmonary Collaterals in Children with Complex Congenital Heart Diseases.Pediatric cardiology · 2026Article
- Article
- Multimodal Imaging from Fetal to Adult Life: A Comprehensive Approach to Hypoplastic Left Heart Syndrome (HLHS).Journal of cardiovascular development and disease · 2025Review
- Single-center perioperative management and 1-year heart transplantation outcomes for patients with adult congenital heart disease.JHLT open · 2025Article
- The majority of pediatric Fontan patients have excellent post-transplant survival.The Journal of thoracic and cardiovascular surgery · 2024Article
- Contemporary Management of the Failing Fontan.Journal of clinical medicine · 2024Review
- Cardiac transplantation in adult congenital heart disease: a narrative review.Journal of thoracic disease · 2023Review
- Fontan-associated liver disease: Diagnosis, surveillance, and management.Frontiers in pediatrics · 2023Review
- Failing Fontan cardiovascular support: Review.Journal of cardiac surgery · 2022Review
- Heart transplantation after Fontan operation.JTCVS techniques · 2022Article
- Management of circulatory failure after Fontan surgery.Frontiers in pediatrics · 2022Review
- Outcomes of treatment for right atrial isomerism with functional single ventricle and extracardiac total anomalous pulmonary venous connection beyond neonatal period: Delayed surgical treatment, improving outcomes.Frontiers 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
- Article
- Transplantation in Fontan failure: The final stage.JTCVS open · 2020Article
- Imaging of complications following Fontan circulation in children - diagnosis and surveillance.Pediatric radiology · 2020Review
- Fontan-Associated Liver Disease: Screening, Management, and Transplant Considerations.Circulation · 2020Review
- Transplant and mechanical circulatory support in patients with adult congenital heart disease.Heart failure reviews · 2020Review
- Transplantation of the failing Fontan.Translational pediatrics · 2019Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundPatients with a failing Fontan continue to have decreased survival after heart transplant (HT), particularly those with preserved ventricular function (PVF) compared with impaired ventricular function (IVF). In this study we evaluated the effect of institutional changes on post-HT outcomes.
methodsData were retrospectively collected for all Fontan patients who underwent HT. Mode of failure was defined by the last echocardiogram before HT, with mild or no dysfunction considered PVF and moderate or severe considered IVF. Outcomes were compared between early era (EE, 1995 to 2008) and current era (CE, 2009 to 2014). Management changes in the CE included volume load reduction with aortopulmonary collateral (APC) embolization, advanced cardiothoracic imaging, higher goal donor/recipient weight ratio and aggressive monitoring for post-HT vasoplegia.
resultsA total of 47 patients were included: 27 in the EE (13 PVF, 14 IVF) and 20 in the CE (12 PVF, 8 IVF). Groups were similar pre-HT, except for more PLE in PVF patients. More patients underwent APC embolization in the CE (80% vs 28%, p < 0.01). There was no difference in donor/recipient weight ratio between eras. There was a trend toward higher primary graft failure for PVF in the EE (77% vs 36%, p = 0.05) but not the CE (42% vs 75%, p = 0.20). Overall, 1-year survival improved in the CE (90%) from the EE (63%) (p = 0.05), mainly due to increased survival for PVF (82 vs 38%, p = 0.04).
conclusionsPost-HT survival for failing Fontan patients has improved, particularly for PVF. In the CE, our Fontan patients had a 1-year post-HT survival similar to other indications.
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