Table 4. Characteristics of ACHD listed for heart, heart-lung and combined organ transplantation.

Characteristics of ACHD patients listed for heart or heart and combined organ transplantation (1,56,59-61)

Younger age of ACHD in comparison to non-ACHD listed for transplantation

Lower prevalence of cardiovascular risk factors or life style risk factors causative for coronary artery disease

Higher prevalence of increased pulmonary vascular resistance in ACHD in comparison to non-ACHD

Impaired nutritional status with patients being underweight especially in patients with protein losing enteropathy

Increased risk of postoperative infections or impaired wound healing

The type of the underlying heart defect with:

• Single ventricle being a common diagnosis in ACHD

• Biventricular defects and their sequelae

• Different underlying disease as reason for transplantation listing due to the shift from lesions with lower complexity to more complex lesions due to progress of medical therapy

Prevalence of previous cardiac surgery is high in ACHD either due to corrective or palliative treatment

Increased difficulty of surgical therapy due to extensive scarring in ACHD or formation of collaterals with a high bleeding risk

ACHD, adults with congenital heart disease.