Evidence map›Paper›PMID 34693238›Full record

ArticleJHEP reports : innovation in hepatology2021

Non-invasive biomarkers of Fontan-associated liver disease.

Juliet Emamaullee, Sara Khan, Carly Weaver, Cameron Goldbeck, George Yanni, Rohit Kohli, Yuri Genyk, Shengmei Zhou, Nick Shillingford, Patrick M Sullivan and 9 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
5.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Unifying and unique roles of non-coding RNA biomarkers in liver and heart fibrosis.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2026
    Review
  7. Article
  8. Article
  9. Review
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Observational
  16. Article
  17. Review
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 2 institutions in 1 country.

Juliet EmamaulleeDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
Sara KhanKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Carly WeaverLiver Transplant Program, Children's Hospital-Los Angeles, Los Angeles, CA, USA.
Cameron GoldbeckDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
George YanniKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Rohit KohliKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Yuri GenykDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
Shengmei ZhouKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Nick ShillingfordKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Patrick M SullivanKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Cheryl TakaoKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Jon DetterichKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Paul F KantorKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
John D ClevelandDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
Cynthia HerringtonDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
S Ram KumarDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
Vaughn StarnesDepartment of Surgery, University of Southern California, Los Angeles, CA, USA.
Sarah BadranKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Neil D PatelKeck School of Medicine, University of Southern California, Los Angeles, CA, USA.
University of Southern California · USChildren's Hospital of Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsFontan-associated liver disease (FALD) has emerged as an important morbidity following surgical palliation of single ventricle congenital heart disease. In this study, non-invasive biomarkers that may be associated with severity of FALD were explored.

methodsA retrospective cohort of paediatric patients post-Fontan who underwent liver biopsy at a high volume at a paediatric congenital heart disease centre was reviewed.

resultsAmong 106 patients, 66% were male and 69% were Hispanic. The mean age was 14.4 ± 3.5 years, and biopsy was performed 10.8 ± 3.6 years post-Fontan. The mean BMI was 20.8 ± 5 kg/m

conclusionsIn this large, relatively homogeneous adolescent population in terms of age, ethnicity, and Fontan duration, bridging fibrosis was observed in 35% of patients within the first decade post-Fontan. Bridging fibrosis was associated with worse survival. Changes in platelet counts, even years before biopsy, and APRI/FIB-4 scores had modest discriminatory power in identifying patients with advanced fibrosis. Steatosis may represent an additional risk factor for disease progression in obese patients. Further prospective studies are necessary to develop strategies to screen for FALD in the adolescent population. LAY SUMMARY: In this study, the prevalence of Fontan-associated liver disease (FALD) in the young adult population and clinical variables that may be predictive of fibrosis severity or adverse outcomes were explored. Several lab-based, non-invasive markers of bridging fibrosis in FALD were identified, suggesting that these values may be followed as a prognostic biomarker for FALD progression in the adolescent population.

Indexed as

ALP, alkaline phosphataseALT, alanine aminotransferaseAPRI, AST-to-platelet ratio indexAST, aspartate aminotransferaseBMI, body mass indexBNP, brain natriuretic peptideBUN, blood urea nitrogenCBC, complete blood countCHFS, congestive hepatic fibrosis scoreCHLT, combined heart–liver transplantationCongenital heart diseaseCongestive hepatopathyCVP, central venous pressureECMO, extracorporeal membrane oxygenationFALD, Fontan-associated liver diseaseFIB-4, fibrosis-4GFR, glomerular filtration rateGGT, gamma-glutamyl transferaseINR, international normalised ratioIQR, interquartile rangeLVAD, left ventricular assist deviceMELD, model of end-stage liver diseaseMELD-Na, MELD-sodiumMELD-XI, MELD without INRNAFLD, non-alcoholic fatty liver diseasePELD, paediatric end-stage liver diseasePT, prothrombin timePTT, partial thromboplastin timeTTE, transthoracic echocardiogramsUniventricular heart disease

Identifiers

PMID34693238
PMCPMC8517550
OpenAlexW3199290808

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.