Extracorporeal membrane oxygenator as a bridge to heart–liver en bloc transplant in a patient with Fontan circulation

Although there is excellent long-term survival of patients who have had a Fontan procedure for single-ventricle phys-iology, many of these patients eventually develop Fontan failure and require heart and, possibly, liver transplanta-tion.1-4 An area of interest is the use of extracorporeal membrane oxygenation (ECMO) in patients with Fontan circulation. Here, we report the first use of ECMO as a bridge to heart-liver en bloc transplant in a female with a history of right ventricle-dominant atrioventricular septal defect who underwent a Fontan procedure (patient consent obtained, institutional review board #295-22; January 3, 2019).