Clinical Outcomes of Adult Fontan-Associated Liver Disease and Combined Heart-Liver Transplantation
Authors' conclusion
Higher FALD scores were associated with post-transplant mortality. Although prospective confirmation of our findings is necessary, compared with HT alone, CHLT recipients were older with higher FALD scores, but had similar survival overall and superior survival in patients with a FALD score ≥2.
Study context
- Population
- Adult Fontan patients (age ≥16 years at referral) referred for and undergoing HT or combined heart-liver transplant (CHLT)
- Participants
- 131 patients
- Exposure
- Combined heart-liver transplant vs heart transplant alone
- CHLTn = 40
- HTn = 91reference
- Outcome
- Post-transplant survival (matched)
Methodological detailsmulticentre (15 centers), matched
- Multicentre (15 centers)
- Matched
Main finding
As reported in the abstract
1-year survival
P = 0.097
5-year survival
P = 0.041
Observational data: associations, not effects.
Further findings
Survival in patients with FALD score ≥2 (subgroup) · 5 years
P = 0.019
1-year survival
P = 0.044
5-year survival
Survival, model adjusted for transplant decade and Fontan-associated liver disease (FALD) score
| HR | P value | |
|---|---|---|
| FALD score 2Worse survival | 14.6 | P = 0.015 |
| FALD score 3Worse survival | 22.2 | P = 0.007 |
| FALD score 4Worse survival | 27.8 | P = 0.011 |
| Outcome | HR | P value |
|---|---|---|
| Survival, model adjusted for transplant decade and FALD scoreCHLT vs HT | 0.33 | P = 0.044 |
Original publication
Clinical Outcomes of Adult Fontan-Associated Liver Disease and Combined Heart-Liver Transplantation. J Am Coll Cardiol. Published 6 June 2023. doi:10.
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