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With advances in the diagnosis and treatment of congenital heart disease (CHD), over 90% of infants born with CHD now reach adulthood. Patients with CHD require lifelong care and are at an increased risk of psychological distress, neurocognitive deficits, social challenges, and a lower quality of life (QOL). There exists limited research on how to best to support the long-term mental healthcare needs of this unique cohort. There remains limited data on directed mental health interventions and their long-term results in adults with CHD (ACHD).

Recent findings indicate high incidences of anxiety and depression in this growing population and how key concepts such as trauma, illness identity, and resilience maybe playing a role in the lives of adult patients with CHD. Attention must be focused to theorize and conduct further research to determine the effectiveness of treatment options based upon these new findings.

Many individuals with CHD do not receive appropriate mental health screening and care. The authors advocate for effective psychosocial interventions to address patients' illness identity and resilience, with the goal of an improved QOL in mind.

Many individuals with CHD do not receive appropriate mental health screening and care. The authors advocate for effective psychosocial interventions to address patients' illness identity and resilience, with the goal of an improved QOL in mind.

Fontan-associated liver disease (FALD) is an emerging condition in patients who have undergone surgical correction of univentricular congenital heart disease. There is little known about the epidemiology of FALD, including risk factors for end-organ failure or hepatocellular carcinoma nor a consensus on surveillance guidelines. Furthermore, there is a need to understand the role of heart versus combined heart-liver transplantation in this population. Research is limited by systemic barriers hindering the ability to track longitudinal FALD outcomes.

Nearly all patients post-Fontan develop histological features of FALD as a function of time post-Fontan, regardless of Fontan hemodynamics. In cases of end-organ disease, single-center studies have shown promising outcomes of combined heart-liver transplant in this population, with decreased rates of acute rejection. However, despite the burden of disease, it is not currently possible to identify the population of patients with FALD using existing clinical databases and registries due to a lack of diagnostic codes.

Strategies proposed to address barriers to understanding FALD include developing appropriate diagnostic and transplant-related codes for existing registries. Efforts should also be targeted at initiating prospective studies to understand recognized comorbidities related to Fontan physiology, guided by a team of multidisciplinary subspecialists.

Strategies proposed to address barriers to understanding FALD include developing appropriate diagnostic and transplant-related codes for existing registries. Efforts should also be targeted at initiating prospective studies to understand recognized comorbidities related to Fontan physiology, guided by a team of multidisciplinary subspecialists.

To review the role of machine perfusion in advancing the study and clinical application of liver xenotransplantation to liver transplantation.

Recent multicenter trial has shown the benefits of normothermic machine perfusion (NMP) in the assessment and selection of suitable allografts for liver transplantation, especially marginal liver allografts. Advances in ex-vivo therapeutic intervention with proof-of-concept studies demonstrating successful ex-vivo genetic modification of donor allografts and blockade of gene expression with siRNA.

Xenotransplantation and NMP are two of the most exciting and eagerly anticipated technologies in organ transplantation. Since the emergence of clinical transplantation, clinicians and researchers have attempted to manipulate xenografts for clinical use or to develop devices that could provide physiologic support of donor organs ex vivo. The past decade has seen significant progress in NMP with recent emergence of devices suitable for use in clinical practice. Following gress in NMP with recent emergence of devices suitable for use in clinical practice. Following discovery of novel gene-editing techniques, xenotransplantation has also developed rapidly with encouraging outcomes in preclinical studies. Xenotransplantation is now currently poised to advance into the clinical realm. read more NMP can not only assist in the development of other novel technologies by providing a unique environment to safely study organ function and assess organ suitability but may also improve outcomes following hepatic xenotransplantation. In this review, we describe the current use of NMP in xenotransplantation research and also discuss the potential roles for NMP in xenotransplantation research and future clinical practice.

The purpose of this review is to present and analyse recent literature on the patterns, trends, and developments of ethical considerations concerning xenotransplantation by appraising normative aspects within a coherent framework.

Developments within xenotransplantation may soon allow for pig-to-human xenotransplantation to take place. Ethical analysis of xenotransplantation commonly follows an anthropocentric cost-benefit analysis, which may imprecisely measure costs. Xenotransplantation should not merely be approached from an anthropocentric perspective. Rather, the potential risks presented to human and nonhuman donors, recipients, and third parties should all be thoroughly considered.

The range of feasible alternatives to xenotransplantation to increase organ supply should be examined before resorting to xenotransplantation because of the moral distinction between imposing certain risks on others before, or after, alternative solutions have been exhausted.

The range of feasible alternatives to xenotransplantation to increase organ supply should be examined before resorting to xenotransplantation because of the moral distinction between imposing certain risks on others before, or after, alternative solutions have been exhausted.