Heart transplantation after Fontan: Results from a surgical Fontan cohort

Kavitha N. Pundi, Krishna Pundi, David J. Driscoll, Joseph A. Dearani, Zhuo Li, Sonja H. Dahl, Bassem N. Mora, Patrick W. O'Leary, Richard C. Daly, Frank Cetta, Jonathan N. Johnson

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

We performed a retrospective review of outcomes after heart transplantation during long-term follow-up of a surgical cohort of 1138 Fontan patients who were followed at the Mayo Clinic. Follow-up information was obtained from medical records and a clinical questionnaire that was mailed to patients not known to be deceased at the initiation of the study. Forty-four of 1138 Fontan patients with initial or subsequent evaluation at Mayo had cardiac transplantation between 1988 and 2014 (mean age at transplantation was 23.2 ± 12 yr, median was 19.8 yr; mean interval between Fontan and transplantation was 13.0 ± 7.7 yr, median was 13.1 yr). Two patients had combined organ transplantation (one heart-lung, one heart-liver). Twelve of the 44 (27%) patients had PLE prior to transplantation. There was no difference in post-bypass Fontan pressures or incidence of late reoperations for AVV repair/replacement between transplanted and non-transplanted patients. There were 16 (36%) deaths in the transplantation cohort; seven occurred within 30 days of transplantation. Overall one, five, 10, and 15 yr post-transplantation survival was 80%, 72%, 69%, and 55%, respectively. Although this is a challenging group of patients, intermediate-term results suggest that cardiac transplantation remains a reasonable option for patients with a failed Fontan circulation.

Original languageEnglish (US)
JournalPediatric Transplantation
DOIs
StateAccepted/In press - 2016

Keywords

  • Fontan procedure
  • Protein-losing enteropathy
  • Transplant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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    Pundi, K. N., Pundi, K., Driscoll, D. J., Dearani, J. A., Li, Z., Dahl, S. H., Mora, B. N., O'Leary, P. W., Daly, R. C., Cetta, F., & Johnson, J. N. (Accepted/In press). Heart transplantation after Fontan: Results from a surgical Fontan cohort. Pediatric Transplantation. https://doi.org/10.1111/petr.12753