☆ 4.0 Review

Review of pediatric combined heart-liver transplantation: A roadmap to success

PEDIATRIC TRANSPLANTATION (2023)

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Review Pediatrics

Deceased donor organ allocation in pediatric transplantation: A historical narrative

Robert Ettenger et al.

Summary: Since the beginning of solid organ transplantation, the allocation of organs for children has been a contentious issue. Different countries have favored some degree of preference for children, but the specific policies and their success rates vary greatly. Further research is needed to optimize allocation strategies for pediatric candidates.

PEDIATRIC TRANSPLANTATION (2023)

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Article Cardiac & Cardiovascular Systems

Predictors of liver cirrhosis and hepatocellular carcinoma among perioperative survivors of the Fontan operation

Ryo Inuzuka et al.

Summary: This study aimed to identify predictors of liver cirrhosis (LC) and hepatocellular carcinoma (HCC) in post-Fontan patients. Through a multi-institutional retrospective cohort study, it was found that high central venous pressure and severe atrioventricular valve regurgitation were independent predictors of LC/HCC.

HEART (2023)

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Article Cardiac & Cardiovascular Systems

Clinical Outcomes of Adult Fontan-Associated Liver Disease and Combined Heart-Liver Transplantation

Matthew J. Lewis et al.

Summary: This study assessed the impact of Fontan-associated liver disease (FALD) on post-transplant outcomes and compared single heart transplant (HT) with combined heart-liver transplant (CHLT) in adult Fontan patients. The results showed that the severity of FALD was associated with post-transplant mortality. Compared with HT alone, CHLT had better survival rates in patients with severe liver disease.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2023)

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Review Transplantation

Update on combined heart and liver transplantation: evolving patient selection, improving outcomes, and outstanding questions

Kaitlyn M. Tracy et al.

Summary: This article reviews the current literature to summarize what is known about patient selection and outcomes and highlights the questions that remain.

CURRENT OPINION IN ORGAN TRANSPLANTATION (2023)

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Editorial Material Cardiac & Cardiovascular Systems

Heart after liver transplantation with domino for a highly sensitized patient

Shin Lin et al.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2023)

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Article Cardiac & Cardiovascular Systems

Hepatorenal dysfunction assessment with the Model for End-Stage Liver Disease Excluding INR score predicts worse survival after heart transplant in pediatric Fontan patients

Shahnawaz Amdani et al.

Summary: This study evaluated the utility of MELD-XI score in identifying Fontan patients at increased risk for morbidity and mortality post-heart transplant. The results showed that patients with high MELD-XI scores had inferior survival post-heart transplant.

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY (2022)

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Article Surgery

Evaluation of Fontan-associated Liver Disease and Ethnic Disparities in Long-term Survivors of the Fontan Procedure A Population-based Study

Juliet Emamaullee et al.

Summary: This study analyzed the long-term outcomes of patients post-Fontan procedure and found an increased all-cause mortality in Hispanic population and a correlation between the incidence of FALD and age. This emphasizes the need for specific liver surveillance strategies in patients post-Fontan.

ANNALS OF SURGERY (2022)

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Article Pediatrics

Fontan-associated liver disease after heart transplant

Eric R. Griffiths et al.

Summary: This multi-center study reviewed Fontan patients undergoing heart transplant and found that post-transplant mortality in these patients was associated with elevated bilirubin levels but not with fibrosis on liver imaging. The study also suggests that heart transplant may alter the progression of Fontan associated liver disease.

PEDIATRIC TRANSPLANTATION (2022)

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Article Surgery

Matching Donor and Recipient Size in Pediatric Heart Transplantation

Tajinder P. Singh et al.

Summary: Previous analyses have not found a relationship between donor-recipient size mismatch and post-transplant mortality in pediatric heart transplant recipients. However, a recent study has developed an equation using body surface area to predict left ventricular mass, which may be associated with post-transplant in-hospital mortality. This study found that the use of predicted LV mass ratio as a measure of size match was associated with a higher risk of early post-transplant mortality in pediatric heart transplant recipients, but it was not superior to the use of donor-recipient weight ratio or BSA ratio for assessing size match.

TRANSPLANT INTERNATIONAL (2022)

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Article Pediatrics

Pretransplantation and Post-Transplantation Liver Disease Assessment in Adolescents Undergoing Isolated Heart Transplantation for Fontan Failure

Dellys Soler Rodriguez et al.

Summary: The study described the assessment of Fontan-associated liver disease in isolated heart transplantation candidates and found that patients with specific criteria can have successful short-term outcomes post-transplantation. Liver MRI and VAST scores improved, while liver biopsy scores did not significantly change. Continued surveillance for hepatic complications post-transplantation for patients with Fontan is recommended.

JOURNAL OF PEDIATRICS (2021)

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Article Cardiac & Cardiovascular Systems

Comparison of combined heart-liver vs heart-only transplantation in pediatric and young adult Fontan recipients

Danielle Sganga et al.

Summary: Comparing Fontan recipients undergoing heart liver transplantation (HLT) with those undergoing heart-only transplantation (HT), despite HLT patients having more severe liver disease and higher inotrope usage at listing, their post-transplant outcomes are comparable. For HT patients, pre-transplant imaging showing cirrhosis is associated with poorer outcomes.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2021)

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Article Immunology

Operative Technique of Donor Organ Procurement for En Bloc Heart-liver Transplantation

Stefan Elde et al.

Summary: Combined heart-liver transplantation is a new option for patients with indications for heart transplantation and limited liver function, particularly for those with single ventricle physiology. The en bloc technique may offer advantages such as improved hemodynamics, decreased bleeding, reduced ischemic time, and lower rates of graft dysfunction.

TRANSPLANTATION (2021)

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Article Pediatrics

Pediatric heart-liver transplant outcomes in the United States: A 25-year National Cohort Study

Swati Choudhry et al.

Summary: Pediatric HLT is a rare but acceptable option for recipients with combined end-organ failure, with intermediate survival outcomes comparable to those of single-organ recipients.

PEDIATRIC TRANSPLANTATION (2021)

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Article Pediatrics

Heterogeneous outcomes of liver disease after heart transplantation for a failed Fontan procedure

Aecha M. Ybarra et al.

Summary: This study evaluated the liver imaging changes in Fontan patients who underwent isolated heart transplant, showing that most patients experienced improvement in liver imaging post-HT. The results emphasize the importance of serial liver imaging follow-up after HT.

PEDIATRIC TRANSPLANTATION (2021)

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Article Gastroenterology & Hepatology

Non-invasive biomarkers of Fontan-associated liver disease

Juliet Emamaullee et al.

Summary: The study examined FALD in the young adult population post-Fontan surgery and identified non-invasive markers associated with bridging fibrosis. Bridging fibrosis was observed in 35% of patients within the first decade post-Fontan and was linked to worse survival. Changes in platelet counts, even years before biopsy, and APRI/FIB-4 scores had modest discriminatory power in identifying patients with advanced fibrosis. Steatosis may represent an additional risk factor for disease progression in obese patients. Further prospective studies are needed to develop strategies for screening FALD in adolescents.

JHEP REPORTS (2021)

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Article Cardiac & Cardiovascular Systems

Routine Surveillance Catheterization is Useful in Guiding Management of Stable Fontan Patients

Neil D. Patel et al.

PEDIATRIC CARDIOLOGY (2020)

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Article Cardiac & Cardiovascular Systems

Fontan-Associated Liver Disease Screening, Management, and Transplant Considerations

Juliet Emamaullee et al.

CIRCULATION (2020)

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Article Surgery

Does liver biopsy accurately measure fibrosis in Fontan-associated liver disease? A comparison of liver biopsy pre-combined heart and liver transplant and liver explant post-transplant

Sumeet S. Vaikunth et al.

CLINICAL TRANSPLANTATION (2020)

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Article Pediatrics

Acute kidney injury and chronic kidney disease after combined heart-liver transplant in patients with congenital heart disease: A retrospective case series

Angela Lee et al.

PEDIATRIC TRANSPLANTATION (2020)

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Review Gastroenterology & Hepatology

Revisiting the liver's role in transplant alloimmunity

Nitin Abrol et al.

WORLD JOURNAL OF GASTROENTEROLOGY (2019)

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Article Cardiac & Cardiovascular Systems

The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report-2019; focus theme: Donor and recipient size match

Kiran K. Khush et al.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2019)

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Article Pediatrics

Pediatric liver transplantation

Alex G. Cuenca et al.

SEMINARS IN PEDIATRIC SURGERY (2017)

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Article Surgery

Liver Allograft Provides Immunoprotection for the Cardiac Allograft in Combined Heart-Liver Transplantation

T. W. Wong et al.

AMERICAN JOURNAL OF TRANSPLANTATION (2016)

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Review Gastroenterology & Hepatology

Size mismatch in liver transplantation

Kyota Fukazawa et al.

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES (2016)

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Review Anesthesiology

Perioperative management of pediatric en-bloc combined heart-liver transplants: a case series review

Manchula Navaratnam et al.

PEDIATRIC ANESTHESIA (2016)

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Article Cardiac & Cardiovascular Systems

Combination of liver biopsy with MELD-XI scores for post-transplant outcome prediction in patients with advanced heart failure and suspected liver dysfunction

Maryjane Farr et al.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2015)

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Article Cardiac & Cardiovascular Systems

Combined Heart and Liver Transplantation Can Be Safely Performed With Excellent Short- and Long-Term Results

Pavan Atluri et al.

ANNALS OF THORACIC SURGERY (2014)

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Article Gastroenterology & Hepatology

Reframing the Impact of Combined Heart-Liver Allocation on Liver Transplant Wait-List Candidates

David S. Goldberg et al.

LIVER TRANSPLANTATION (2014)

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Article Cardiac & Cardiovascular Systems

Features of portal hypertension are associated with major adverse events in Fontan patients: The VAST study

Robert W. Elder et al.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2013)

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Article Cardiac & Cardiovascular Systems

Intermediate-term outcomes after combined heart-liver transplantation in children with a univentricular heart

Seth A. Hollander et al.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2013)

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Article Pediatrics

Pediatric combined heart-liver transplantation performed en bloc: A single-center experience

Amy L. Hill et al.

PEDIATRIC TRANSPLANTATION (2012)

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Article Cardiac & Cardiovascular Systems

Outcomes following more than two decades of paediatric cardiac transplantation

Claire A. Irving et al.

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY (2011)

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Article Pediatrics

Low donor-to-recipient weight ratio does not negatively impact survival of pediatric heart transplant patients

Liwen Tang et al.

PEDIATRIC TRANSPLANTATION (2010)

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Article Cardiac & Cardiovascular Systems

Hepatic changes in the failing Fontan circulation

Christoph H. Kiesewetter et al.

HEART (2007)

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Article Immunology

Case report of combined pediatric heart-lung-liver transplantation

SK Gandhi et al.

TRANSPLANTATION (2002)

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