Review of pediatric combined heart‐liver transplantation: A roadmap to success
Background Combined heart‐liver transplantation (CHLT) is a promising technique to address end stage organ failure in patients with concomitant heart failure and chronic liver disease. While most experience with CHLT has involved adult patients, the expanding population of children born with univent...
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Published in | Pediatric transplantation Vol. 27; no. 8; pp. e14633 - n/a |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Denmark
Wiley Subscription Services, Inc
01.12.2023
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Subjects | |
Online Access | Get full text |
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Summary: | Background
Combined heart‐liver transplantation (CHLT) is a promising technique to address end stage organ failure in patients with concomitant heart failure and chronic liver disease. While most experience with CHLT has involved adult patients, the expanding population of children born with univentricular congenital heart disease who underwent the Fontan procedure and develop Fontan‐associated liver disease (FALD) has emerged as a growing indication for pediatric CHLT.
Methods
Currently, CHLT is performed at a select subset of experienced transplant centers, especially in the pediatric population.
Results
While technically demanding, CHLT may offer survival benefit when compared to heart transplant alone with decreased rejection of both synchronous allografts and equivalent outcomes with respect to waitlist time and post‐operative complications. Limitations in the technique can be attributed to need for an appropriate multidisciplinary care center, challenges with donor organ availability and allocation, and the complexity associated with patient selection and peri‐operative management.
Conclusion
In this review, we summarize the history of CHLT, discuss patient selection, and highlight key facets of peri‐operative care in the pediatric population. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
ISSN: | 1397-3142 1399-3046 1399-3046 |
DOI: | 10.1111/petr.14633 |