{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:36:45Z","timestamp":1788514605829,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL147957"],"award-info":[{"award-number":["R01HL147957"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      With an increasing number of Fontan patients surviving into adulthood, the burden of end-stage heart failure is increasing. Prior studies have reported suboptimal heart transplantation (HTx) outcomes. Therefore, the authors describe their institutional experience of HTx in patients with Fontan circulation failure, including\n                      <jats:italic>en-bloc<\/jats:italic>\n                      heart-liver transplantation (HLTx) and pretransplant systemic ventricular assist device (SVAD) therapies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive Fontan-palliated patients undergoing HTx or HLTx between 2013 and 2022 at the authors\u2019 institution were included. Pretransplant characteristics and posttransplant outcomes were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-six transplant recipients, including 5 (19%) HLTx recipients, were identified. The majority (n\u2009=\u200916, 62%) of patients had a cardiac diagnosis of hypoplastic left heart syndrome. Seven (26%) patients were bridged to transplant on an SVAD; the median duration of support was 104 [IQR 39-543] days. Transplantation occurred at a median of 10.6 [IQR 6.8-15.6] years post-Fontan. Fourteen (54%) patients had \u22651 in-hospital complication and 4 (15%) patients required an in-hospital reoperation. Postdischarge reinterventions included tricuspid valve repair (n\u2009=\u20091, 4%) and retransplantation (n\u2009=\u20091, 4%). Two (8%) in-hospital mortalities [22 days (post-HLTx), 2.9 months (post-HTx] and 4 (15%) postdischarge mortalities [5.4 months, 3.1 years, 5.7 years, 7.1 years (all post-HTx)] occurred. Overall survival was excellent, with in-hospital, one-year, and five-year actuarial survival being 92%, 89%, and 80%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current series demonstrates that excellent posttransplant outcomes are achievable for patients with Fontan circulation failure using a comprehensive approach including SVAD and HLTx therapies. Pretransplant optimization, sometimes including SVAD implantation, and meticulous operative planning are imperative strategies for successful patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351241305127","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T19:37:57Z","timestamp":1736969877000},"page":"368-375","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Heart Transplantation Outcomes for Fontan Patients When Using Contemporary Strategies: Heart-Liver Transplantation and Ventricular Assist Device Therapy"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-3715","authenticated-orcid":false,"given":"Spencer J.","family":"Hogue","sequence":"first","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason W.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Mehdizadeh-Shrifi","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chet R.","family":"Villa","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford","family":"Chin","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Lorts","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Opotowsky","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Lehenbauer","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L. 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