Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T15:50:50.234Z Has data issue: false hasContentIssue false
  • English
  • Français

Heart transplant after the Fontan operation

Published online by Cambridge University Press:  09 January 2014

Joseph W. Rossano  and
Robert E. Shaddy
Joseph W. Rossano
Affiliation:
Department of Pediatrics, Perelman School of Medicine, The Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
Robert E. Shaddy*
Affiliation:
Department of Pediatrics, Perelman School of Medicine, The Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: R. E. Shaddy, MD, The Children's Hospital of Philadelphia, Division of Cardiology, 34th Street and Civic Center Boulevard, Room 8NW80, Philadelphia, PA 19104, United States of America. Tel: 267-426-7518; Fax: 267-426-0950; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Although the Fontan operation may provide a durable circulation for some patients with functionally univentricular hearts for several decades, circulatory failure becomes more common over time. Medical and/or surgical interventions can improve the circulation for some period of time; however, many patients will experience end-stage circulatory failure. Heart transplantation may be considered in these patients. This review will cover the indications and evaluation for heart transplantation, management of patients while waiting for heart transplantation and the current outcomes of transplantation in this population.

Keywords

Fontanheart transplantheart failure
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 6: HeartWeek 2013 , December 2013 , pp. 841 - 846
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rossano, JW, Goldberg, DJ, Mott, AR, et al. Hospitalizations in single ventricle patients in the United States: prevalence and outcomes from 2000 to 2006 (abstract). J Am Coll Cardiol 2012; 59: A180.Google Scholar
2.Canter, CE, Shaddy, RE, Bernstein, D, et al. Indications for heart transplantation in pediatric heart disease: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young; the Councils on Clinical Cardiology, Cardiovascular Nursing, and Cardiovascular Surgery and Anesthesia; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007; 115: 658–676.Google Scholar
3.Ostrow, AM, Freeze, H, Rychik, J. Protein-losing enteropathy after Fontan operation: investigations into possible pathophysiologic mechanisms. Ann Thorac Surg 2006; 82: 695–700.Google Scholar
4.Griffiths, ER, Kaza, AK, Wyler von Ballmoos, MC, et al. Evaluating failing fontans for heart transplantation: predictors of death. Ann Thorac Surg 2009; 88: 558–563; discussion 563–554.Google Scholar
5.Rychik, J, Veldtman, G, Rand, E, et al. The precarious state of the liver after a Fontan operation: summary of a multidisciplinary symposium. Pediatr Cardiol 2012; 33: 1001–1012.Google Scholar
6.Hollander, SA, Reinhartz, O, Maeda, K, Hurwitz, M, Rosenthal, D, Bernstein, D. Intermediate-term outcomes after combined heart-liver transplantation in children with a univentricular heart. J Heart Lung Transplant 2013; 32: 368–370.CrossRefGoogle ScholarPubMed
7.Kaufman, BD, Shaddy, RE. Immunologic considerations in heart transplantation for congenital heart disease. Curr Cardiol Rev 2011; 7: 67–71.Google Scholar
8.Shaddy, RE, Hunter, DD, Osborn, KA, et al. Prospective analysis of HLA immunogenicity of cryopreserved valved allografts used in pediatric heart surgery. Circulation 1996; 94: 1063–1067.Google Scholar
9.Shaddy, RE, Fuller, TC. The sensitized pediatric heart transplant candidate: causes, consequences, and treatment options. Pediatr Transplant 2005; 9: 208–214.CrossRefGoogle ScholarPubMed
10.Holt, DB, Lublin, DM, Phelan, DL, et al. Mortality and morbidity in pre-sensitized pediatric heart transplant recipients with a positive donor crossmatch utilizing peri-operative plasmapheresis and cytolytic therapy. J Heart Lung Transplant 2007; 26: 876–882.Google Scholar
11.Pollock-BarZiv, SM, den Hollander, N, Ngan, BY, et al. Pediatric heart transplantation in human leukocyte antigen sensitized patients: evolving management and assessment of intermediate-term outcomes in a high-risk population. Circulation 2007; 116: I172–I178.CrossRefGoogle ScholarPubMed
12.Bernstein, D, Naftel, D, Chin, C, et al. Outcome of listing for cardiac transplantation for failed Fontan: a multi-institutional study. Circulation 2006; 114: 273–280.Google Scholar
13.Simpson, KE, Cibulka, N, Lee, CK, Huddleston, CH, Canter, CE. Failed Fontan heart transplant candidates with preserved vs impaired ventricular ejection: 2 distinct patient populations. J Heart Lung Transplant 2012; 31: 545–547.Google Scholar
14.Copeland, JG, Copeland, H, Gustafson, M, et al. Experience with more than 100 total artificial heart implants. J Thorac Cardiovasc Surg 2012; 143: 727–734.CrossRefGoogle ScholarPubMed
15.Morales, DL, Zafar, F, Gaynor, JW, et al. The worldwide use of syncardia total artificial heart in patients with congenital heart disease (abstract). J Heart Lung Transplant 2013; 32: S288.Google Scholar
16.Pretre, R, Haussler, A, Bettex, D, Genoni, M. Right-sided univentricular cardiac assistance in a failing Fontan circulation. Ann Thorac Surg 2008; 86: 1018–1020.Google Scholar
17.Nathan, M, Baird, C, Fynn-Thompson, F, et al. Successful implantation of a Berlin heart biventricular assist device in a failing single ventricle. J Thorac Cardiovasc Surg 2006; 131: 1407–1408.Google Scholar
18.Giridharan, GA, Koenig, SC, Kennington, J, et al. Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist. J Thorac Cardiovasc Surg 2013; 145: 249–257.Google Scholar
19.Rodefeld, MD, Coats, B, Fisher, T, et al. Cavopulmonary assist for the univentricular Fontan circulation: von Kármán viscous impeller pump. J Thorac Cardiovasc Surg 2010; 140: 529–536.Google Scholar
20.Kirk, R, Dipchand, AI, Edwards, LB, et al. The registry of the International Society for Heart and Lung Transplantation: fifteenth pediatric heart transplantation report–2012. J Heart Lung Transplant 2012; 31: 1065–1072.Google Scholar
21.Rossano, JW, Morales, DL, Zafar, F, et al. Impact of antibodies against human leukocyte antigens on long-term outcome in pediatric heart transplant patients: an analysis of the united network for organ sharing database. J Thorac Cardiovasc Surg 2010; 140: 694–699, 699.e1–e2.CrossRefGoogle ScholarPubMed
22.Rossano, JW, Grenier, MA, Dreyer, WJ, et al. Effect of body mass index on outcome in pediatric heart transplant patients. J Heart Lung Transplant 2007; 26: 718–723.Google Scholar
23.Rajagopal, SK, Yarlagadda, VV, Thiagarajan, RR, Singh, TP, Givertz, MM, Almond, CS. Pediatric heart failure and worsening renal function: association with outcomes after heart transplantation. J Heart Lung Transplant 2012; 31: 252–258.Google Scholar
24.Kovach, JR, Naftel, DC, Pearce, FB, et al. Comparison of risk factors and outcomes for pediatric patients listed for heart transplantation after bidirectional Glenn and after Fontan: an analysis from the pediatric heart transplant study. J Heart Lung Transplant 2012; 31: 133–139.Google Scholar
25.Davies, RR, Sorabella, RA, Yang, J, Mosca, RS, Chen, JM, Quaegebeur, JM. Outcomes after transplantation for “failed” Fontan: a single-institution experience. J Thorac Cardiovasc Surg 2012; 143: 1183–1192; e1184.CrossRefGoogle Scholar