{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:42:58Z","timestamp":1788514978954,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T00:00:00Z","timestamp":1626912000000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fontan\u2010associated liver disease (FALD) uniformly affects patients with long\u2010term Fontan physiology. The effect of isolated heart transplant (HT) on the course of FALD post\u2010HT is not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated serial liver imaging pre\u2010 and post\u2010HT to assess liver changes over time in a single\u2010center retrospective analysis of Fontan HT recipients who had pre\u2010 and \u22651\u2010year post\u2010HT liver imaging. Available patient demographic and clinical data were reviewed, including available liver biopsy results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serial liver imaging was available in 19 patients with a median age at HT of 12\u00a0years (range 3\u201323), the median age from Fontan to HT of 5.7\u00a0years (range 0.8\u201316), and the median time from imaging to follow up of 27\u00a0months (range 12\u2013136\u00a0months). Pre\u2010HT liver imaging was classified as follows: normal (n=1), congested (n=9), fibrotic (n=7), and cirrhotic (n=2). The majority of transplanted patients (15\/19) had improvement in their post\u2010HT liver imaging, including 13 patients with initially abnormal imaging pre\u2010HT having normal liver imaging at follow\u2010up. One patient had persistent cirrhosis at 26\u2010month follow\u2010up, one patient had unchanged fibrosis at 18\u2010month follow\u2010up, and one patient progressed from fibrosis pre\u2010HT to cirrhosis post\u2010HT at 136\u00a0months. No patients had overt isolated liver failure during pre\u2010 or post\u2010HT follow\u2010up. Liver biopsy did not consistently correlate with imaging findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Post\u2010HT liver imaging evaluation in Fontan patients reveals heterogeneous liver outcomes. These results not only provide evidence for the improvement of FALD post\u2010HT but also show the need for serial liver imaging follow\u2010up post\u2010HT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14094","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T01:59:35Z","timestamp":1627005575000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Heterogeneous outcomes of liver disease after heart transplantation for a failed Fontan procedure"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-407X","authenticated-orcid":false,"given":"Aecha M","family":"Ybarra","sequence":"first","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetika","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Radiology Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumirle P","family":"Turmelle","sequence":"additional","affiliation":[{"name":"Department of Radiology Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janis","family":"Stoll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chesney D","family":"Castleberry","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Scheel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis MO 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F","family":"Birnbaum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Missouri\u2010Kansas City  Kansas City MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernat","family":"Exil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E","family":"Canter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen E","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis MO 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