{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:51:31Z","timestamp":1781635891654,"version":"3.54.5"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010391","name":"Tokyo Women's Medical University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010391","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CEN Case Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Fontan procedure is a palliative surgical technique used for complex congenital heart disease resulting in a functional single ventricle. Patients with Fontan circulation often exhibit elevated central venous pressure (CVP) and reduced cardiac output, which make intermittent hemodialysis (IHD) challenging. Between dialysis sessions, increased preload due to fluid accumulation may precipitate congestive heart failure, whereas excessive ultrafiltration can reduce preload and consequently compromise cardiac output. We report the case of a 23-year-old man with a single ventricle of left ventricular morphology who underwent a Fontan procedure at 2\u00a0years of age. He developed kidney failure secondary to bilateral hypoplastic kidneys and began peritoneal dialysis (PD) at 12\u00a0years of age. PD was continued for 9\u00a0years because IHD and kidney transplantation were contraindicated due to cardiac dysfunction with arrhythmia. He presented with a refractory exit-site infection, for which laparoscopic surgery revealed early-stage encapsulating peritoneal sclerosis. Cardiac catheterization revealed a CVP of 11\u201312\u00a0mmHg, and ventricular function was preserved. Based on these findings, transition to IHD was considered feasible. Permanent pacemaker implantation and insertion of a tunneled hemodialysis catheter were performed concurrently. IHD was initiated at a blood flow rate of 150\u00a0mL\/min, which was well tolerated, with no episodes of hemodynamic instability observed. The patient has since been maintained on outpatient IHD for 9\u00a0months without major complications. This case demonstrates that IHD can be safely performed in selected patients with Fontan circulation, provided that careful preoperative hemodynamic assessment is undertaken to confirm adequate cardiovascular stability.<\/jats:p>","DOI":"10.1007\/s13730-026-01091-9","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T05:59:45Z","timestamp":1770098385000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful transition from long-term peritoneal dialysis to intermittent hemodialysis in a patient with Fontan circulation"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-0251","authenticated-orcid":false,"given":"Ryo","family":"Nakatani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-4766","authenticated-orcid":false,"given":"Yoko","family":"Shirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Shinkawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Segawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Hanafusa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9483-8482","authenticated-orcid":false,"given":"Kenichiro","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"1091_CR1","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1136\/hrt.2004.051789","volume":"91","author":"M Gewillig","year":"2005","unstructured":"Gewillig M. The fontan circulation. Heart. 2005;91:839\u201346. https:\/\/doi.org\/10.1136\/hrt.2004.051789.","journal-title":"Heart"},{"key":"1091_CR2","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1161\/CIRCULATIONAHA.114.005341","volume":"130","author":"J Rychik","year":"2014","unstructured":"Rychik J, Goldberg DJ. Late consequences of the Fontan operation. Circulation. 2014;130:1525\u20138. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.114.005341.","journal-title":"Circulation"},{"key":"1091_CR3","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jjcc.2016.04.001","volume":"68","author":"H Ohuchi","year":"2016","unstructured":"Ohuchi H. Adult patients with Fontan circulation: what we know and how to manage adults with Fontan circulation? J Cardiol. 2016;68:181\u20139. https:\/\/doi.org\/10.1016\/j.jjcc.2016.04.001.","journal-title":"J Cardiol"},{"key":"1091_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1227-3","volume":"20","author":"L Bitker","year":"2016","unstructured":"Bitker L, Bayle F, Yonis H, et al. Prevalence and risk factors of hypotension associated with preload-dependence during intermittent hemodialysis in critically ill patients. Crit Care. 2016;20:44. https:\/\/doi.org\/10.1186\/s13054-016-1227-3.","journal-title":"Crit Care"},{"key":"1091_CR5","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1136\/heartjnl-2015-307467","volume":"102","author":"M Gewillig","year":"2016","unstructured":"Gewillig M, Brown SC. The Fontan circulation after 45\u2005years: update in physiology. Heart. 2016;102:1081\u20136. https:\/\/doi.org\/10.1136\/heartjnl-2015-307467.","journal-title":"Heart"},{"key":"1091_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedcp.2024.200110","volume":"11","author":"Y Shirai","year":"2024","unstructured":"Shirai Y, Miura K, Ando T, et al. Asymptomatic early-stage encapsulating peritoneal sclerosis identified\u00a0laparoscopically. J Pedia: Clinic Pract. 2024;11:200110. https:\/\/doi.org\/10.1016\/j.jpedcp.2024.200110.","journal-title":"J Pedia: Clinic Pract"},{"key":"1091_CR7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.ijcha.2018","volume":"21","author":"B Young","year":"2018","unstructured":"Young B, Franklin W, Lam W, et al. Single-center experience of hemodialysis in patients after Fontan palliation. Int J Cardiol Heart Vasc. 2018;21:94\u20135. https:\/\/doi.org\/10.1016\/j.ijcha.2018.","journal-title":"Int J Cardiol Heart Vasc."},{"key":"1091_CR8","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.1040869","volume":"10","author":"SD Martin","year":"2022","unstructured":"Martin SD, Lande MB, Kuebler JD, et al. Case report and review of the literature: successful transition from acute continuous veno-venous hemodiafiltration therapy to chronic peritoneal dialysis in a chronically ventilated child with hypoplastic left heart syndrome following fontan. Front Pediatr. 2022;10:1040869. https:\/\/doi.org\/10.3389\/fped.2022.1040869.","journal-title":"Front Pediatr"},{"key":"1091_CR9","doi-asserted-by":"publisher","first-page":"2958","DOI":"10.1016\/j.ekir.2021.09.009","volume":"6","author":"MA Sohail","year":"2021","unstructured":"Sohail MA, Vachharajani TJ, Anvari E. Central venous catheters for hemodialysis\u2014the myth and the evidence. Kidney Int Rep. 2021;6:2958\u201368. https:\/\/doi.org\/10.1016\/j.ekir.2021.09.009.","journal-title":"Kidney Int Rep"},{"key":"1091_CR10","doi-asserted-by":"publisher","first-page":"343","DOI":"10.3747\/pdi.2008.00273","volume":"30","author":"T Yamamoto","year":"2010","unstructured":"Yamamoto T, Nagasue K, Okuno S, et al. The role of peritoneal lavage and the prognostic significance of mesothelial cell area in preventing encapsulating peritoneal sclerosis. Perit Dial Int. 2010;30:343\u201352. https:\/\/doi.org\/10.3747\/pdi.2008.00273.","journal-title":"Perit Dial Int"},{"key":"1091_CR11","doi-asserted-by":"publisher","first-page":"S205","DOI":"10.1177\/089686080802803s38","volume":"28","author":"H Kawanishi","year":"2008","unstructured":"Kawanishi H, Moriishi M, Ide K, et al. Recommendation of the surgical option for treatment of encapsulating peritoneal sclerosis. Perit Dial Int. 2008;28:S205\u201310. https:\/\/doi.org\/10.1177\/089686080802803s38.","journal-title":"Perit Dial Int."},{"key":"1091_CR12","doi-asserted-by":"publisher","first-page":"3403","DOI":"10.1007\/s00467-025-06826-x","volume":"40","author":"S Okada","year":"2025","unstructured":"Okada S, Kamei K, Nishi K, et al. Successful living donor kidney transplantation in a 14-year-old boy with Fontan circulation. 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