Document Detail

Noninvasive Assessment of Liver Fibrosis in Adult Patients Following the Fontan Procedure.
MedLine Citation:
PMID:  22360766     Owner:  NLM     Status:  Publisher    
Objective.  Recent data indicate that patients after the Fontan procedure are at risk for significant liver dysfunction; however, the prevalence and extent of liver disease in the Fontan population remains unknown. Furthermore, limited data exist in regard to screening for liver disease in adult Fontan patients. We sought to determine the prevalence of liver disease in adult patients following the Fontan procedure using computed tomography (CT) and serum biomarkers of liver fibrosis. Design.  Adult Fontan patients underwent screening for liver disease as part of their annual evaluation. Screening consisted of laboratory evaluation and dual-phase liver CT scan. Laboratory evaluation included analysis of liver function, viral hepatitis serologies, and FibroSURE panel (LabCorp), a test that analyzes the results of serum biomarkers to provide a quantitative surrogate marker for liver fibrosis. Results.  Sixteen patients, mean age 30.3 (range 20-41) years, were enrolled in the study. Mean length of follow-up from time of Fontan palliation was 20.5 (range 11-33) years. No patients had serologic evidence of viral hepatitis or synthetic liver dysfunction. Twelve patients (75%) had abnormal FibroSURE scores, seven (44%) had elevated FibroSURE scores predictive of Metavir fibrosis stage F2 or greater on liver biopsy, and one (6%) had a FibroSURE score predictive of cirrhosis on biopsy. All 16 patients had abnormal radiologic liver findings identified on CT, including heterogeneous enhancement in 11 (69%), varices in six (38%), and liver nodules in five patients (31%). Length of time since Fontan surgery correlated significantly with an elevated FibroSURE score (P = .05) and having more CT scan abnormalities (P = .04). Conclusions.  Liver fibrosis detected by serum biomarkers and dual phase CT scan is common in adult patients following the Fontan procedure. Further studies are needed to determine the long-term clinical significance of these findings.
Salil Ginde; Mark D Hohenwalter; W Dennis Foley; Jane Sowinski; Peter J Bartz; Suneetha Venkatapuram; Catherine Weinberg; James S Tweddell; Michael G Earing
Related Documents :
21821226 - Clinical and prognostic implications of the initial response to aspirin in patients wit...
2184006 - Managing elevated blood lipid concentrations. who, when and how?
21953486 - Detection of icp0 protein in tear fluid of individuals with active herpetic epithelial ...
22806436 - Response to imatinib mesylate in patients with hypereosinophilic syndrome.
12049566 - Fiberoptic examination of the pharyngoesophageal segment in tracheoesophageal speakers.
312016 - Felty's syndrome without splenomegaly.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-23
Journal Detail:
Title:  Congenital heart disease     Volume:  -     ISSN:  1747-0803     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Departments of Pediatrics, Division of Pediatric Cardiology Radiology Internal Medicine, Division of Cardiovascular Medicine Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wis, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The effect of treatment with a sustained-release prostacyclin analogue (ONO-1301-loaded PLGA microsp...
Next Document:  Infrared Photodissociation Spectroscopy of Mononuclear Iron Carbonyl Anions.