Liver Fibrosis Scores Predict Mortality in Complex Congenital Heart Disease
A retrospective study of 334 adults with Fontan circulation—a palliative procedure for congenital heart disease—has demonstrated that non-invasive biomarkers of liver fibrosis are strong predictors of transplant-free survival. The research, published in *Heart*, analyzed scores including FibroSURE, APRI, FIB-4, and MELD-XI over a median follow-up of 5.6 years. It found that elevated scores on all four indices were significantly associated with an increased hazard of death or transplant, with MELD-XI >18 showing a particularly stark 24-fold increased risk. This work confirms that liver disease, a common long-term complication of the Fontan state, has serious prognostic implications that can be tracked with readily available clinical tools.
Why it might matter to you:
For hepatologists managing patients with complex cardiometabolic conditions, this study validates the clinical utility of simple fibrosis scores in a high-risk population. It underscores the critical intersection of liver and heart disease, where portal hypertension and cirrhosis often develop silently. Incorporating these prognostic biomarkers into routine surveillance could help stratify risk and guide earlier intervention or referral for transplant evaluation in this challenging patient group.
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