SynthesisHepatology communications2024
Clinical predictors and noninvasive imaging in Fontan-associated liver disease: A systematic review and meta-analysis.
Synthesis in Hepatology communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Childhood Liver-Related Abnormalities After Fontan Completion: Evidence from a 20-Year Tertiary Centre Cohort.Pediatric cardiology · 2026Article
- Unifying and unique roles of non-coding RNA biomarkers in liver and heart fibrosis.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2026Review
- Two-dimensional shear wave elastography in Fontan-associated liver disease: a narrative review.Abdominal radiology (New York) · 2026Review
- Article
- Long-Term Care in Fontan Circulation: Surveillance and Management of Fontan-Associated Liver Disease and Protein-Losing Enteropathy.Current cardiology reports · 2026Review
- Prognostic biomarkers in Fontan associated liver disease.Translational pediatrics · 2026Review
- Ultrasound Evaluation of Fontan-Associated Liver Disease: A State-of-the-Art Review.Diagnostics (Basel, Switzerland) · 2025Review
- Unifying FALD assessment-A call to arms.Hepatology communications · 2025Article
- Efficacy of Magnetic Resonance Elastography in Fontan-Associated Liver Disease.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Non-invasive fibrosis tools lack clinical utility for identifying advanced fibrosis in Fontan-associated liver disease: a retrospective cohort study.BMJ open gastroenterology · 2025Article
- Evaluation of red cell distribution width-to-platelet ratio and other laboratory markers in staging Fontan-associated liver disease.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2025Article
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Authors and funding
11 authors.
Funding
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Abstract
backgroundDespite the development of several imaging modalities for diagnosing Fontan-associated liver disease (FALD), there is no optimal protocol for the follow-up of FALD. We conducted a systematic review and meta-analysis to identify factors related to liver fibrosis using biopsy reports and to identify alternative noninvasive modalities that could better reflect liver histological changes in FALD.
methodsA systematic review and meta-analysis were conducted following the PRISMA guidelines Table S2. We searched Embase, PubMed, and Cochrane databases for studies on FALD, focusing on those assessing clinical factors associated with liver fibrosis severity through liver biopsy and noninvasive imaging techniques.
resultsA total of 42 studies were identified, of which 12 conducted meta-analyses and subgroup analyses of the severity of liver fibrosis using liver biopsies. Liver biopsy results showed a weak positive correlation between Fontan duration and fibrosis severity (R = 0.36). Subgroup analyses revealed significant differences in hemodynamic parameters, such as Fontan pressure, between patients with mild and severe fibrosis. Platelet count, aspartate aminotransferase to platelet ratio index, and fibrosis-4 index were significantly associated with fibrosis severity, with severe fibrosis showing lower platelet counts and higher aspartate aminotransferase to platelet ratio index and fibrosis-4 index levels. Noninvasive imaging modalities, particularly magnetic resonance elastography and shear wave elastography, demonstrated strong correlations with biopsy-confirmed fibrosis severity.
conclusionsThis study identifies key clinical factors, and noninvasive modalities accurately reflect liver fibrosis severity in patients with FALD. Clinical factors such as platelet count, aspartate aminotransferase to platelet ratio index, and fibrosis-4 index may aid in identifying patients at risk for severe fibrosis. In addition, magnetic resonance elastography and shear wave elastography are promising tools for noninvasive assessment in our study. Further research is needed to refine these diagnostic approaches and improve patient management.
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