{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:07:57Z","timestamp":1783944477696,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Combined heart\u2010liver transplantation (CHLT) is a high\u2010risk procedure that is infrequently performed in select patients with end\u2010stage heart and liver disease. This study details a single center experience with simultaneous (en bloc or sequential) CHLT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single center retrospective review of 12 simultaneous CHLT performed over a 12\u2010year period. Studied variables included basic clinical data, intraoperative and postoperative details, and outcomes. A comparison of our outcomes to the national cohort was also performed using the UNOS registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve CHLTs (five pediatric, seven adult) were performed between 2011 and 2023. Mean age was 32\u00a0years (range 7\u201362\u00a0years, 75% male). Congenital heart disease with cardiac cirrhosis (58%) and amyloidosis (25%) were the most common indications. Liver and heart wait list times were 125 and 116\u00a0days, respectively. The majority of CHLTs were performed en\u2010bloc (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a08; 67%) and four (33%) were performed sequentially (liver following heart). Mean post\u2010operative ICU and total length of stay (LOS) were 16 and 28\u00a0days, respectively, with six patients requiring unplanned return to OR (three for hemoperitoneum, three for hemopericardium). There were no intraoperative deaths, and one patient died on POD 1 from hyperacute rejection. None of the patients required re\u2010transplant after a median follow\u2010up of 37.5\u00a0months. Both overall and graft survival for the cohort at 1\u2010, 3\u2010, and 5\u2010years remained 92%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CHLT remains the only viable option for carefully selected patients with end\u2010stage heart and liver failure and is associated with excellent patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70277","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T13:45:21Z","timestamp":1755524721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Combined Heart and Liver Transplantation: A Single Center Experience and Review of National Data"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1958-4926","authenticated-orcid":false,"given":"Amen Z.","family":"Kiani","sequence":"first","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Lindemann","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeta","family":"Vachharajani","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela L.","family":"Hill","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1716-9000","authenticated-orcid":false,"given":"Diego F.","family":"Chaparro","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7807-9180","authenticated-orcid":false,"given":"Sakil S.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hepatology Department of Pediatrics St Louis Children'S Hospital  St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janis","family":"Stoll","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hepatology Department of Pediatrics St Louis Children'S Hospital  St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A. F.","family":"Henkel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hepatology Department of Pediatrics St Louis Children'S Hospital  St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirooz","family":"Eghtesady","sequence":"additional","affiliation":[{"name":"Section of Cardiothoracic Surgery Department of General Surgery St. Louis Children'S Hospital, Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilip","family":"Nath","sequence":"additional","affiliation":[{"name":"Section of Cardiothoracic Surgery Department of General Surgery St. Louis Children'S Hospital, Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob R.","family":"Miller","sequence":"additional","affiliation":[{"name":"Section of Cardiothoracic Surgery Department of General Surgery St. Louis Children'S Hospital, Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Chapman","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majella B.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5073-4238","authenticated-orcid":false,"given":"Adeel S.","family":"Khan","sequence":"additional","affiliation":[{"name":"Section of Abdominal Transplant Department of General Surgery Washington University in St. Louis  St. Louis Missouri 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