{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:39:54Z","timestamp":1787510394266,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T00:00:00Z","timestamp":1554940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Patients with failing Fontan physiology and liver cirrhosis are being considered for combined heart and liver transplantation. We performed a retrospective review of our experience with\n                    <jats:italic>en bloc<\/jats:italic>\n                    combined heart and liver transplantation in Fontan patients\u00a0&gt;\u00a010\u00a0years old from 2006 to 18 per Institutional Review Board approval. Six females and 3 males (median age 20.7, range 14.2\u201041.3\u00a0years) underwent\n                    <jats:italic>en bloc<\/jats:italic>\n                    combined heart and liver transplantation. Indications for heart transplant included ventricular dysfunction, atrioventricular valve regurgitation, arrhythmia, and\/or lymphatic abnormalities. Indication for liver transplant included portal hypertension and cirrhosis. Median Fontan\/single ventricular end\u2010diastolic pressure was 18\/12\u00a0mm\u00a0Hg, respectively. Median Model for End\u2010Stage Liver Disease excluding International Normalized Ratio score was 10 (7\u201026), eight patients had a varices, ascites, splenomegaly, thrombocytopenia score of\u00a0\u2265\u00a02, and all patients had cirrhosis. Median cardiopulmonary bypass and donor ischemic times were 262 (178\u2010307) and 287 (227\u2010396) minutes, respectively. Median intensive care and hospital stay were 19 (5\u201096) and 29 (13\u2010197) days, respectively. Survival was 100%, and rejection was 0% at 30\u00a0days and 1\u00a0year post\u2010transplant.\n                    <jats:italic>En bloc<\/jats:italic>\n                    combined heart and liver transplantation is an acceptable treatment in the failing Fontan patient with liver cirrhosis.\n                  <\/jats:p>","DOI":"10.1111\/ctr.13540","type":"journal-article","created":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T03:20:07Z","timestamp":1553052007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Short\u2010term outcomes of\n                    <i>en bloc<\/i>\n                    combined heart and liver transplantation in the failing Fontan"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-3548","authenticated-orcid":false,"given":"Sumeet S.","family":"Vaikunth","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldo","family":"Concepcion","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tami","family":"Daugherty","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Lutchman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhide","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Teuteberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. 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