Addressing Complexities in Fontan Combined Heart-Liver Transplantation: A Collaborative Perspective

Jeannette Lin; Lorraine Lubin; Leigh Reardon; Gentian Lluri; Jamil Aboulhosn; Daniel Cruz; Darko Vucicevic; Christopher Wray; Sammy Saab; Robert Venick; Fady Kaldas; Ming-Sing Si; Reshma Biniwale; Glen Van Arsdell

doi:10.1053/j.pcsu.2025.02.004

Addressing Complexities in Fontan Combined Heart-Liver Transplantation: A Collaborative Perspective

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2025:28:117-123. doi: 10.1053/j.pcsu.2025.02.004. Epub 2025 Feb 17.

Authors

Affiliations

¹ Ahmanson/UCLA Adult Congenital Heart Disease Center, Division of Adult Cardiology, Los Angeles, California.
² UCLA Department of Anesthesiology and Perioperative Medicine, Los Angeles, California.
³ Ahmanson/UCLA Cardiomyopathy Center, Los Angeles, California.
⁴ UCLA Department of Medicine, Pfleger Liver Institute, Los Angeles, California.
⁵ Department of Pediatric Gastroenterology, Los Angeles, California.
⁶ UCLA Department of Surgery, Pfleger Liver Institute, Los Angeles, California.
⁷ UCLA Department of Surgery, Cardiothoracic Surgery, Los Angeles, California.
⁸ UCLA Department of Surgery, Cardiothoracic Surgery, Los Angeles, California. Electronic address: gvanarsdell@mednet.ucla.edu.

PMID: 40382115
DOI: 10.1053/j.pcsu.2025.02.004

Abstract

In Fontan circulatory failure, heart or combined heart-liver transplantation (CHLT) is considered a final therapeutic option. Fontan patients present unique challenges for the cardiac and liver transplant teams. Improving outcomes of CHLT in Fontan patients requires a multidisciplinary team approach to patient selection, meticulous surgical planning, intraoperative and postoperative management, and continuous learning.

Keywords: Fontan; combined heart-liver transplantation; failing Fontan.

Publication types

Review

MeSH terms

Fontan Procedure* / adverse effects
Fontan Procedure* / methods
Heart Defects, Congenital* / surgery
Heart Transplantation* / methods
Humans
Liver Transplantation* / methods
Patient Care Team
Patient Selection