Liver Fibrosis Scores Predict Mortality in Complex Congenital Heart Disease
A retrospective cohort study of 334 adults with Fontan circulation—a palliative surgical procedure for congenital heart disease—has demonstrated that non-invasive biomarkers of liver fibrosis are potent prognostic indicators. The research, published in *Heart*, analyzed scores including FibroSURE, APRI, FIB-4, and MELD-XI. Over a median follow-up of 5.6 years, elevated scores were strongly associated with an increased hazard of death or transplant. For instance, a FibroSURE score above 0.74 was linked to a more than threefold increased hazard, while a MELD-XI score above 18 was associated with a dramatic 24-fold increased hazard. This work confirms that liver health, assessed through readily available serum markers, is a critical determinant of long-term survival in this vulnerable patient population.
Why it might matter to you: For a gastroenterologist or hepatologist, this study underscores the expanding clinical utility of non-invasive fibrosis biomarkers beyond primary liver diseases. It highlights your potential role in multidisciplinary teams managing patients with Fontan-associated liver disease (FALD), where portal hypertension and cirrhosis are common complications. Integrating these prognostic scores into routine surveillance could help stratify risk and guide timely referrals for advanced therapies, including transplant evaluation.
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