Associated Factors of Liver Disease After Fontan Operation in Relation to Ultrasound Liver Elastography

AbstractAlthough the Fontan operation can improve outcomes, surviving patients still face Fontan-associated liver disease (FALD). The aim of this study was to determine the associated factors of FALD in relation to ultrasound liver elastography. A cross-sectional study was conducted for all patients on whom an ultrasound upper-abdomen and ultrasound liver elastography was performed at more than 1  year after the Fontan operation. The data consisted of the age at operation, type of Fontan operation, and laboratory data such as gamma-glutamyl transferase (GGT), aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) score. Cardiovascular evaluations included echocard iography and cardiac catheterization. Eighty patients with a median age of 12 years (range 5–36 years) were eligible for the study. The prevalence of FALD was 41%. For the purpose of univariate logistic regression analysis, the age at the Fontan operation, time elapsed since the Fontan operation , previous Glenn shunt, presence of fenestration, mean pulmonary artery pressure and IVC pressure post-Fontan operation, platelet count, GGT, and FIB-4 score were considered to be factors significantly associated with FALD. Following an adjustment by multivariate logistic regression analysis, age gr eater than 7 years at the time of Fontan procedure, time elapsed of more than 9 years since the procedure, and GGT level >  130 U/L were found to be significantly associated with FALD. Patie...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research