Observational Study
Copyright ©The Author(s) 2025.
World J Gastroenterol. Mar 21, 2025; 31(11): 103178
Published online Mar 21, 2025. doi: 10.3748/wjg.v31.i11.103178
Table 2 Characteristics of study population comparing non-advanced Fontan-associated liver disease with advanced Fontan-associated liver disease, mean ± SD/n (%)
General and cardiologic characteristics
Total (n = 74)
Non-advanced FALD (n = 20)
Advanced FALD (n = 54)
P value
Male45 (60.8)11 (55.0)34 (63.9)NS
Age, years33.0 ± 7.532.2 ± 8.933.2 ± 7.0NS
Age, years, median (IQR)32.0 (28.0-38.0)32.5 (23.0-39.0)32.0 (28.0-37.0)
BMI, kg/m2, median (IQR)22.4 (20.3-25.7)24.3 (20.3-26.0)22.2 (19.6-24.9)NS
Time since Fontan, median (IQR)23.0 (19.0-27.5)21.0 (18.0-28.0)23.0 (20.0-27.0)NS
Type of congenital heart diseaseNS
Pulmonary atresia or stenosis41 (55.4)10 (50.0)31 (57.4)
Tricuspid atresia31 (41.9)11 (55.0)20 (37.0)
Transposition of great arteries26 (35.1)7 (35.0)19 (35.2)
Doble outlet right ventricle12 (16.2)3 (15.0)9 (16.7)
Doble inlet left ventricle8 (10.8)1 (5.0)7 (13.0)
Left heart/ventricle hypoplasia10 (13.5)2 (10.0)8 (14.8)
Right heart/ventricle hypoplasia12 (16.2)2 (10.0)10 (18.5)
Mitral atresia7 (9.5)1 (5.0)6 (11.1)
Type of surgeryNS
Atriopulmonary16 (21.9)3 (15.8)13 (24.1)
Bicavopulmonary
Intra-atrial lateral conduit6 (8.2)2 (10.5)4 (7.4)
Extracardiac conduit51 (69.9)14 (73.7)37 (68.5)
Fontan conduit stenosis30 (41.1)4 (20.0)26 (49.1)0.033
Oxygen saturation, %, median (IQR)92.0 (91.0-95.0)94.0 (92.5-96.0)92.0 (90.0-94.0)0.007
Laboratory investigations and serological/clinical scores
Hemoglobin, g/dL, median (IQR)16.3 (14.5-17.6)16.2 (14.5-17.0)16.3 (14.5-17.6)NS
Platelet count, × 103/L, median (IQR)130.0 (111.0-169.0)162.0 (142.0-198.0)120.0 (97.0-150.0)< 0.001
Prothrombin, %, median (IQR)73.0 (50.0-82.5)73.0 (34.5-87.9)72.5 (51.0-81.0)NS
INR, median (IQR)1.1 (1.1-1.4)1.1 (1.1-1.4)1.2 (1.1-1.4)NS
AST, UI/L, median (IQR)28.0 (23.5-33.0)29.0 (23.0-36.0)28.0 (23.5-32.0)NS
ALT, UI/L, median (IQR)31.5 (23.5-43.0)34.0 (22.5-44.0)31.0 (24.0-42.0)NS
ALP, UI/L, median (IQR)81.0 (66.0-108.0)73.5 (62.5-84.0)87.0 (66.0-114.0)NS
GGT, UI/L, median (IQR)77.0 (54.5-124.0)62.5 (43.0-89.5)80.5 (60.0-140.0)0.025
Total bilirubin, mg/dL, median (IQR)1.4 (0.9-2.1)0.9 (0.7-1.8)1.5 (1.0-2.2)0.030
Direct bilirubin, mg/dL, median (IQR)0.7 (0.6-1.0)0.6 (0.4-1.0)0.7 (0.6-1.0)NS
Creatinine, mg/dL, median (IQR)0.8 (0.7-0.9)0.9 (0.7-0.9)0.8 (0.7-0.9)NS
Sodium, mEq/L, median (IQR)140.0 (138.9-141.0)140.0 (139.0-142.0)140.0 (138.0-141.0)NS
Albumin, g/dL, median (IQR)4.6 (4.3-4.9)4.7 (4.5-4.8)4.6 (4.3-4.9)NS
Total cholesterol, mg/dL, median (IQR)139.0 (122.0-161.5)142.5 (129.0-150.5)137.5 (118.5-163.5)NS
AFP, ng/mL, median (IQR)2.4 (1.6-4.4)2.4 (2.0-3.1)2.3 (1.5-4.9)NS
NT-proBNP, pg/mL, median (IQR)223.0 (100.0-579.0)181.0 (82.0-453.0)246.0 (107.0-737.0)NS
APRI, median (IQR)0.51 (0.37-0.71)0.40 (0.33-0.63)0.53 (0.39-0.77)0.024
FIB-4, median (IQR)1.1 (0.9-1.7)1.0 (0.7-1.3)1.2 (0.9-1.9)0.028
Forns index, median (IQR)5.7 (5.0-6.8)5.0 (4.3-5.6)6.3 (5.4-7.2)< 0.001
MELD, median (IQR)9 (7-11)8 (7-9)10 (8-11)0.024
MELD-Na, median (IQR)10 (8-12)7 (7-9)10 (8-12)0.007
MELD-XI, median (IQR)12 (9-13)10 (9-13)12 (10-14)0.040
Child-Pugh0.084
A (5-6)67 (90.5)20 (100.0)47 (87.0)
B (7-9)7 (9.5)0 (0.0)7 (13.0)
VAST ≥ 242 (75.0)0 (0.0)42 (93.4)< 0.001
Ultrasonography and transient elastography
Heterogenous liver echogenicity46 (63.0)7 (35.0)39 (73.6)0.006
Nodular liver surface44 (60.3)6 (30.0)38 (71.7)0.003
Hepatomegaly30 (40.5)3 (15.0)27 (50.0)0.008
Abnormal caudate42 (57.5)5 (25.0)37 (69.8)0.001
Portal vein dilation7 (9.6)1 (5.0)6 (11.3)NS
Splenomegaly46 (62.2)0 (0.0)46 (85.2)< 0.001
Collateral circulation17 (23.0)0 (0.0)17 (31.5)0.004
Portosystemic shunts6 (8.1)0 (0.0)6 (11.1)NS
Ascites, gradeNS
059 (79.7)19 (95.9)40 (74.1)
110 (13.5)1 (5.0)9 (16.7)
25 (6.8)0 (0.0)5 (9.3)
Liver stiffness, kPa, median (IQR)26.8 (20.3-34.3)19.0 (13.0-30.0)29.5 (22.6-36.4)0.001

  • Citation: Cuadros M, Abadía M, Castillo P, Martín-Arranz MD, Gonzalo N, Romero M, García-Sánchez A, García-Samaniego J, Olveira A, Ruiz-Cantador J, González-Fernández Ó, Ponz I, Merás P, Merino C, Rodríguez-Chaverri A, Balbacid E, Froilán C. Role of transient elastography in the diagnosis and prognosis of Fontan-associated liver disease. World J Gastroenterol 2025; 31(11): 103178
  • URL: https://www.wjgnet.com/1007-9327/full/v31/i11/103178.htm
  • DOI: https://dx.doi.org/10.3748/wjg.v31.i11.103178