Cohort study
Morbidity and Mortality in Adult Fontan Patients After Heart or Combined Heart-Liver Transplantation
- Retrospective cohort study
- multicentre
- 15 centres in the US and Canada
Authors' conclusion
In our multicenter cohort, post-transplant survival improved over time. Late referral after Fontan failure and markers of failing Fontan physiology, including worse functional status, lower extremity varicosities, and venovenous collaterals, were associated with post-transplant mortality.
Study context
- Population
- Adult Fontan patients (age ≥16 years at referral) who underwent heart transplantation (HT) or combined heart-liver transplant (CHLT), 1995–202140 CHLT
- Participants
- 131 patients
- Outcome
- Post-transplant survival and predictors of post-transplant mortality
Main finding
As reported in the abstract
Post-transplant survival
Survival at 1 year
79%
Survival at 5 years
66%
Survival at 1 year, transplant after 2010
87%
Survival at 5 years, transplant after 2010
76%
Observational data: associations, not effects.
Further findings
Predictors of decreased post-transplant survival · 1 year
| Comparison | Estimate | P value | |
|---|---|---|---|
| Time from Fontan failure to evaluation · bivariate model including transplant decade | HR/year 1.23 (95% CI 1.11–1.36) | P < 0.001 | |
| NYHA functional class IV · bivariate model including transplant decade | HR 2.29 (95% CI 1.10–5.28) | P = 0.050 | |
| Lower extremity varicosities · bivariate model including transplant decade | HR 3.92 (95% CI 1.68–9.14) | P = 0.002 | |
| Venovenous collaterals · bivariate model including transplant decade | HR 2.70 (95% CI 1.17–6.20) | P = 0.019 | |
| 0.10.31310Ratio (log scale) |
Original publication
Morbidity and Mortality in Adult Fontan Patients After Heart or Combined Heart-Liver Transplantation. J Am Coll Cardiol. Published 6 June 2023. doi:10.1016/j.jacc.2023.03.422
Summarised from the published abstract; every number is checked against it