Abstract 16311: Survival of Fontan Patients After Heart Transplant; Has Survival Improved in the Current Era?

Heart transplant (HT) after the Fontan procedure has been associated with increased mortality compared to other pediatric heart diseases. Recent data from the Pediatric Heart Transplant Study demonstrated improved survival after HT over time in children with congenital heart disease (CHD). We hypothesized that this trend extends to Fontan patients undergoing HT in the current era. Between 1993 to December 2012, 680 pediatric patients who were ≥ 2 years old at listing with CHD underwent HT, of which 254 had a prior Fontan Procedure. Era 1 (1993-2006: 175 Fontan, 376 non-Fontan CHD (NF-CHD)) was compared to Era 2 (2007-2012: 197 Fontan, 221 NF-CHD) for listed patients ≥ 2 years old. An analysis of survival and risk factors by multivariable analysis examined our study hypothesis. Similar to other groups, Fontan patients in the late era were more likely to be listed as status 1 (69 vs. 90%, p<0.0001), require inotropic support (55 vs. 69%, p=0.0218), have failure to thrive (20 vs. 36%, p=0.0038) and were youn...