Cardiothoracic & vascular anesthesia
Perioperative Characteristics and Outcomes of Fontan Versus Non-Fontan Patients Undergoing Combined Heart-Liver Transplantation: A Retrospective Cohort Study
Authors' conclusion
Combined heart-liver transplantation in patients with Fontan-associated end-organ disease is particularly challenging and associated with higher recipient morbidity compared with non-Fontan-related CHLT.
Study context
- Population
- Consecutive adult recipients of combined heart-liver transplantation (CHLT), Vanderbilt University Medical Center, April 2017–February 2022
- Participants
- 16 consecutive adult recipients
- Exposure
- Fontan vs non-Fontan
- Fontann = 11
- non-Fontann = 5reference
- Outcome
- CPB duration
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
P = m0.002
Observational data: associations, not effects.
Further findings
Extracorporeal membrane oxygenation (ECMO) requirement
- Patients requiring ECMO
- 6 of 16
- Fontan patients requiring ECMO, all of whom subsequently died
- 4
Post-liver-reperfusion characteristics, ECMO vs no ECMO
- 5-hour lactate clearance lower with ECMO: 0.0 vs 3.5 mmol/L
- P = 0.001
- Pulmonary artery pulsatility index lower with ECMO: 0.58 vs 1.77
- P = 0.03
- Peak inspiratory pressure higher with ECMO: 28.0 vs 18.5 mmHg
- P = 0.01
- Higher number of vasoactive infusions with ECMO
Original publication
Perioperative Characteristics and Outcomes of Fontan Versus Non-Fontan Patients Undergoing Combined Heart-Liver Transplantation: A Retrospective Cohort Study. J Cardiothorac Vasc Anesth. Published 4 December 2023. doi:10.
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