Transjugular liver biopsy in Fontan-associated liver disease in children: assessment of safety and diagnostic value compared with noninvasive techniques

Transjugular liver biopsy in Fontan-associated liver disease in children: assessment of safety and diagnostic value compared with noninvasive techniques | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Transjugular liver biopsy in Fontan-associated liver disease in children: assessment of safety and diagnostic value compared with noninvasive techniques Rebeca Del Álamo Peña, María del Mar Tolín Hernani, Carmen Miranda Cid, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8219296/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives To evaluate transjugular liver biopsy (TJLB) as a safe and effective diagnostic option in pediatric patients with liver disease secondary to Fontan surgery and to compare the histological results with those of noninvasive diagnostic tests in relation to the degree of liver fibrosis (LF). Methods A retrospective, single-center study of children under 18 years, Fontan surgery, underwent TJLB from 2019 to the present. Sociodemographic variables, type of heart disease, age at surgery, laboratory test results, ultrasound and liver elastography results, time to TJLB, hemodynamic study results, and degree of LF were collected. Results From 2019 to 2024, 28 TJLBs were performed on 26 patients: 75% male. The mean age at surgery was 5.5 ± 1 year (range: 3.6–8 years). The mean age at the time of biopsy was 16 ± 1.5 years (12–18 years). Ninety-three percent of patients were receiving antiplatelet therapy. Upper gastrointestinal endoscopy showed 36% grade II esophageal varices and 25% grade I. All patients underwent catheterization and hemodynamic evaluation after the procedure. Thirty-nine percent had platelets less than 150,000, and 35% ALT elevated (30.9 ± 17.4 IU/L, range 9–87 IU/L). Six patients had alpha-fetoprotein levels, all in normal range. Ultrasonography revealed normal results in three patients (11%), 57% homogeneous hepatomegaly, 25% parenchymal heterogeneity, and 7% liver nodules. Fifty-seven percent showed ultrasound-guided splenomegaly (11.6 ± 2.8 cm (range: 8–18 cm)), with a platelet-to-spleen ratio of 16.2 ± 6.7 (range: 4.6–2.7). Normal liver doppler in 36%; only two patients experienced portal flow reversal, and one increased portal vein. Elastography performed in 68% of patients: F4 METAVIR fibrosis in 63% and F2-F3 fibrosis in 37% (13.25 ± 4 kPa; range: 7–20 kPa). No significant differences between liver-free pressure and wedge pressure. Liver biopsies revealed grade 4 fibrosis in only 21.4%, and 64% grade 2 or 3 fibrosis. The most frequent histological involvement was sinusoidal dilatation with perisinusoidal fibrosis (86%), associated with centrocentral fibrous bridges in 43%. There was only one complication after TJLB: a mild encapsulated hepatic hematoma autocontrolled and two mild pneumothoraces after jugular vein cannulation. In the comparative study, the histological grade of LF did not correlate statistically significantly with other noninvasive indices. Conclusions TJLB is a safe and effective technique, performed concurrently with procedures such as gastrointestinal endoscopy and catheterization, with a low complication rate. In our series, the degree of fibrosis measured by elastography overestimated the degree of fibrosis measured by histological study. Fontan associated liver disease transjugular liver biopsy elastography children Figures Figure 1 Introduction Fontan-associated liver disease (FALD) is a unique form of congestive hepatopathy (CH) that occurs in patients who have undergone Fontan palliation for functional single-ventricle congenital heart defects (CHDs). FALD represents a spectrum of disease, ranging from liver fibrosis to cardiac cirrhosis, portal hypertension (PHTN), and hepatocellular carcinoma (HCC) 1 . Since 1970, the palleative Fontan operation has allowed the survival of hundreds of patients with single-ventricle-type congenital heart diseases. The principle of intervention involves a surgical cavopulmonary connection, and the right heart takes over the functionality of the left side. Among other effects, systemic venous blood shows significant hemodynamic changes, including elevated central venous pressure and diminished cardiac output 2 . Improved surgical techniques and postoperative patient care have contributed to increased long-term survival rates among children who underwent surgery after 2001, with a 10-year 95% survival rate 3 . New Fontan physiology causes changes in other systems, such as the liver, intestine, pulmonary system or brain, whose pathophysiology remains unknown. Fontan-associated liver disease (FALD) represents a broad spectrum of liver dysfunctions ranging from mild fibrosis to established cirrhosis and has been identified in up to 80% of patients after Fontan 4 . Patients with underlying FALD also show a wide spectrum of manifestations over the years: asymptomatic initial liver congestion and sinusoidal dilation, fibrosis without portal hypertension (with possible regenerative nodules), advanced fibrosis with compensated/decompensated cirrhosis and portal hypertension (with eventual focal nodular hyperplasia, hepatocellular carcinoma, ascites, bleeding from esophagogastric varices or hepatic encephalopathy) 5 . A well-established risk factor is time since surgery (especially more than 10 years). Laboratory and imaging abnormalities are common in the setting of FALD but do not strictly correlate with disease stage. Liver biopsy is a cornerstone in the diagnosis and staging of most liver diseases 6 . To date, noninvasive methods that correlate with the histological evolution of FALD to establish liver damage early have been identified. Recent guidelines from the European Association for the Study of the Liver (EASL) recommend transjugular rather than percutaneous liver biopsy in patients with Fontan physiology because of decreased bleeding and the possibility of performing cardiac catheterization at the same time 7 , 8 . The aims of this study were to analyze the efficacy and safety of transjugular liver biopsy (TJLB) as a diagnostic option in pediatric patients undergoing the Fontan procedure ten years after the procedure and to compare the liver biopsy findings obtained from this biopsy with those of other diagnostic and imaging tests to predict the evolution of FALD. Methods A retrospective, single-center, cross-sectional study was performed using a pseudonymized review of Fontan patients under 18 years of age recruited from a large center specializing in pediatric congenital heart disease and followed at the Pediatric Cardiology Service and Gastroenterology, Hepatology, and Nutrition Unit of the Gregorio Marañón Maternal and Child Hospital in Madrid who underwent transjugular liver biopsy between 2019 and 2024. The inclusion criteria were as follows: age under 18 years, a history of operations involving the creation of Fontan circulation, ability to provide informed consent, stable clinical condition during evaluation, and liver sonoelastography, performed in conjunction with a panel of laboratory tests within the last six months from transjugular liver biopsies. The exclusion criteria were acute clinical deterioration during evaluation, conditions requiring immediate surgical or interventional treatment, pregnancy, a positive test result for hepatitis B surface antigen (HBsAg), a positive test result for hepatitis C virus antibodies, a past diagnosis of hepatitis B or C, autoimmune diseases causing chronic liver damage, and severe ascites preventing reliable liver stiffness (LS) assessment via ultrasound. Before the procedures, all patients underwent upper digestive endoscopy to identify varicose lesions secondary to possible portal hypertension. All patients included underwent transjugular liver biopsy (TJLB) via a standard technique with Seldinger access to the right internal jugular vein. A 38.5-cm long 10-French (sheath was advanced over a 0.035-inch guidewire into the IVC. A 6-F catheter was then used to select the right hepatic vein for portal manometry, including wedged and free pressure. Next, the catheter was exchanged for the 7-F stiffened cannula, which was advanced through the sheath and positioned in the right hepatic vein. A 19-gauge biopsy needle with a 20-mm tray was then advanced through the hepatic vein wall into the hepatic parenchyma under fluoroscopic guidance. For TJLB, the attainment of at least one core was considered adequate tissue sampling. Adequate biopsy samples were defined as the presence of ≥ 11 portal tracts. Liver histological data were obtained from the pathology reports following review by experienced histopathologists. Fibrosis was staged according to the congestive hepatic fibrosis score (CHFS) staging system 9 . After the procedure, all the patients were observed, and vital signs were monitored for at least 4 hours. No heparin was administered during the biopsy segment of the procedure. Biopsies were not performed for patients whose international normalized ratio (INR) was greater than or equal to 3.0 or whose platelet count was less than 50000. The study also involved a retrospective analysis of data obtained from routine diagnostics of Fontan patients at our center. The following variables were collected from medical records: type of Fontan surgery; laboratory tests, such as complete blood count, platelet count, liver enzymes, and APRI calculation; coagulation status; viral hepatic serological panels; medications received; endoscopic studies; and ultrasound‒Doppler and elastographic studies performed by experienced operators closer to TJLB for less than 6 months. Fibrosis was staged according to the congestive hepatic fibrosis score (CHFS) staging system. The severity of liver stiffness (LS) was assessed via the METAVIR scoring system (F1–F4), with F3 and F4 categorized as severe Fontan-associated liver disease (FALD). In addition, noninvasive liver state indices were calculated via laboratory test results and published formulas for parameters such as the AST/ALT ratio, APRI, FIB-4, and GGT/ALT. The APRI was calculated as (AST/30 of AST) × 100/platelet count (10⁹/l), and FIB-4 was calculated as (age × AST)/(platelet count (10⁹/l) × √ALT) 10 . The data were analyzed via SPSS V.29 software. Descriptive statistics were used to assess differences in the characteristics of the study population. Continuous variables are presented as the means (standard deviations) or medians (interquartile ranges [IQRs]), whereas qualitative data are summarized as counts and percentages. The Mann‒Whitney U test was used to assess the strength of relationships between nonnormally distributed values. The independent samples median test was used to evaluate whether two separate groups differed in central tendency. The independent samples t test was used to compare continuous variables with a normal distribution. A p value of less than 0.05 was considered statistically significant. Factors associated with the degree of fibrosis histology were evaluated via linear regression analysis, followed by multiple regression analysis employing the forced entry method for variables with a p value of less than 0.05 in the univariate model. Spearman’s rank correlation was also performed as a nonparametric sensitivity analysis to account for the small sample size and to confirm the reliability of the association. The study was approved by the Research Ethics Committee of Hospital General Universitario (H.G.U.) Gregorio Marañón, Madrid, Spain, in accordance with the Declaration of Helsinki. All procedures were performed with informed consent within the framework of the current clinical protocol approved in 2019 (Fig. 1 ). Results A total of 28 biopsies were performed between January 2019 and December 2024 in 26 patients with left congenital heart disease who underwent the Fontan procedure. Most of the Fontan procedures included were not fenestrated (30%) or used conduits (70%). The most prevalent anatomical diagnosis was Hypoplastic Left Heart Syndrome (HLHS) or Hypoplastic left heart complex in 50 %, double inlet right or left ventricle in 28,5 %, L-Transposition of the great arteries, D-Transposition of the great arteries and double outlet right or left ventricle in 18 %, tricuspid atresia, pulmonary atresia with intact ventricular septum in only 3,5 %. Eighty-one percent of the patients were from the Community of Madrid, and only 19% were from other regions of Spain. 75% were male. The mean age at the time of Fontan surgery was 5.5 ± 1 year (range: 3.6–8 years), that at the time of biopsy was 16.1 ± 1.4 years (range: 12–18 years), and the mean time since surgery was 10.6 ± 1.5 years (range: 6.7–13.7 years). With respect to their usual medications, 92% of patients were taking acetylsalicylic acid, 23% were taking sildenafil, 1% were taking beta-blockers, and anticoagulants were used. One hundred percent of the biopsies achieved technical and histological success, defined as obtaining 2–3 liver tissue cores and a sample sufficient for accurate histopathological diagnosis. In one patient, access was gained through the left internal jugular vein, secondary to situs inversus. No patient presented with obstruction of the upper compartment, which would have prevented the use of a transjugular approach. Three procedure-related complications with spontaneous resolution were recorded: one minor encapsulated hepatic hematoma and two minors apical pneumothoraces following jugular vein cannulation. One patient died after heart transplantation more than two years after our study. No other liver or oncological complications were observed during follow-up. In terms of noninvasive blood analysis findings, thirty-five percent of patients presented elevated ALT (30.9 ± 17.4 U/L, range 9–87 U/L), and 39% presented with thrombocytopenia (<150,000 platelets/qL). The platelet-to-spleen ratio was 16.2 ± 6.7 cm (range: 4.6–27 cm). Only one patient had low levels of total protein and albumin. Alpha-fetoprotein testing was performed in six patients, with elevated levels found in only one patient (Table 1). No patient had blood glucose levels below normal. Immunoglobulin levels were normal in all patients. No patient had positive serology for hepatotropic viruses. The normal values used were as follows: ALT: < 40 IU/dl; AST: < 45 IU/dl; GGT: < 60. IU/dl; total protein: 6–8.3 mg/dl; albumin: 3.5–5 mg/d; alphafetoprotein: 2.1 mg/dl; Pro-BNP (for children aged 10–18 years) 11 : < 300 pg/ml; FIB 4: <1.3: AST/platelets: 0.5–1.5. The findings from the imaging, ultrasound, Doppler and elastography tests are shown in Table 2. Fifty-seven percent of patients had ultrasound splenomegaly, with a mean value of 11.6 ± 2.8 cm (8–18 cm). During Doppler studies, no patients showed a decrease in portal velocity or an increase in the IP over 13.5. The mean elastography value was 13.25 ± 4 kPa (7–20 kPa), with the highest degree of fibrosis in more than 60% of patients. In the upper gastrointestinal endoscopy study performed prior to the transjugular liver biopsy procedure, 61% of patients presented with esophageal varices (25% grades I and 36% grade II). No grade III or IV varices or gastropathy were observed in any of the subjects. A total of 79% of patients underwent catheterization with hepatic hemodynamic evaluation by introducing a balloon catheter and measuring free and hepatic enclosure pressures, revealing increases in both pressures (13.7 ± 4.5 (range: 5–22) and 12.5 ± 4.5 (range 4–21) mm Hg, respectively) above normal values (minus 5 mm Hg) in 96.5% of patients but with a gradient hepatic pressure within normality in all of them (1.5 ± 0.9 (range 1–3) mm Hg) as a representation of hepatic vascular congestion in these patients. In univariate and multivariate analyses of the histological fibrosis grade with different laboratory data, ultrasound data, elastography data, and activity indices, such as the AST/platelet ratio, platelet/splenomegaly ratio, and FIB4 index, no statistically significant correlations were detected. Table 3 shows the degree of correlation and statistical significance. On the other hand, the elastography data were correlated with activity indices, but no statistically significant correlation was found (Table 4). Discussion Improvements in surgical techniques and perioperative management have increased the survival rate of patients who undergo Fontan procedures in childhood, reaching rates of 80% at 20 years. Consequently, complications in the long term have increased, with liver disease being one of the most relevant due to its impact on morbidity and mortality 12 . Liver disease in patients with Fontan physiology begins during childhood and is common. The spectrum of liver disease ranges from mild to moderate and is reliably detected only by liver biopsy; most of our patients are asymptomatic, except for those with hepatomegaly and weak liver enzyme disorders 13 , 14 . Our hospital is a national referral center for congenital heart disease. Since 2010, we have treated more than 180 patients from various regions via the Fontan procedure. Our study is the first in pediatric patients after Fontan procedures in Spain. While some studies in adults include pediatric patients over 16 years of age 4 , few studies have focused on pediatric patients, such as ours 13 . As has been reported, there is a high risk of developing cirrhosis and cholangiocarcinoma, even in the absence of cirrhosis. After 10 years of Fontan surgery, we developed a clinical protocol that begins early evaluation of these patients, starting 5 years post-surgery, using clinical, laboratory, and imaging biomarkers. If any of these markers are abnormal, histological examination via liver biopsy is indicated. In cases of minimal variation in biomarkers, histological follow-up will be performed starting at 10 years, as proposed by other groups 14 . Until a noninvasive study of liver pathology has been validated, liver biopsy will continue to be the gold standard for identifying and staging liver disease in children with Fontan physiology. Transjugular liver biopsy, as our study demonstrated, is considered an equally effective technique for histological evaluation in FALD as percutaneous biopsy is. Nevertheless, the percutaneous route is expected to be the most informative, especially when performed with ultrasound guidance, allowing for the selection of the most abnormal regions. While transjugular biopsy may introduce a sampling bias, as it preferentially samples the perivascular region, which may theoretically be more affected by venous congestion, the transjugular approach has some advantages; it provides additional endoscopic evaluation and liver hemodynamic data performed during cardiac catheterization. A recent cohort of percutaneous liver biopsies confirmed this population’s high risk of bleeding, with a 7.1% postprocedural hemorrhage rate compared with 3.2% reported with the transjugular route, and the control of bleeding was easier 15 , 16 . In our study, we obtained 2–3 liver tissue cores and a sample sufficient for accurate histopathological diagnosis via the TJVIA, which achieved technical and histological success. Three minor procedure-related complications with spontaneous resolution were recorded, two of which were related to jugular vein cannulation, and only one hepatic hematoma was encapsulated, like other series 15 . No other complications were observed during the procedures or during the follow-up. Other alternatives have been described, such as transfemoral liver biopsy, which avoids passing a rigid cannula through the Fontan canal and the right pulmonary artery, which could cause arrhythmias or vascular damage 9 . Noninvasive measures of liver health, including biochemical markers and ultrasound, should be used to guide consultation from specialists in hepatology and consider liver biopsy to define the extent of liver disease. To assess the progression of fibrosis early, Horie et al demonstrated that a fibrosis-4 index greater than 0.17, measured at 2 years post-Fontan, was a strong predictor for Fontan, which was associated with liver disease development 10 years later. In addition, FIB-4 could be considered a good predictor of disease progression in other chronic liver diseases 17 . However, in our series, we were unable to demonstrate a significant correlation between elevated FIB4 levels and the degree of histological fibrosis ten years after Fontan surgery, probably because of the mild or moderate fibrosis levels obtained and the sample size of our cohort. Although different laboratory biomarkers, such as the APRI, γ-GTP, or BNP, have been shown to be positively correlated with the progression of fibrosis in adult patients with FALD 18 , there are many limitations in confirming these correlations in the pediatric cohort with the histological findings of the TJLB. Even so, certain guidelines continue to consider serological and combined serum-clinical tests (aspartate aminotransferase-to-platelet ratio index [APRI], ELF, FIB-4, Forns index, and FibroTest®) used in other liver disease etiologies have modest discriminatory power to identify patients with severe fibrosis and congestive progression and cannot be routinely recommended for staging liver disease in children. In other words, the usefulness of different imaging techniques for predicting the progression of fibrosis in adults with FALD also varies. In abdominal imaging, typical findings include FALD, hepatomegaly, atrophy of the right lobe, and hypertrophy of the caudate and left lobes, which become more apparent as the duration of the Fontan circulation increases. However, most findings are unspecific, except for heterogeneous and irregular periphereal nodules 19 . In advanced fibrosis and cirrhosis, the liver becomes less compliant, and the hepatic veins are dilated. In our series, ultrasound revealed that hepatomegaly was the most frequent finding, with heterogeneous and peripheral nodules present in more than a quarter of the patients. Another frequent finding was significant splenomegaly (greater than 10 cm in diameter), which was observed in more than half of the patients. However, in our cohort, no significant correlation was demonstrated between these findings and the degree of histological fibrosis. With respect to the Doppler studies performed on our patients, most showed no significant or specific findings. Only a small number showed minor changes in flow, reversal or monophasic flow. Many of these findings are frequently observed in adults with chronic pathology, with only the lack of three-phase blood flow of hepatic veins being secondary to the loss of the atrial beat. In our series, none of these findings correlated significantly with a higher degree of histological fibrosis 20 . In recent decades, different liver elastography techniques, such as point shear-wave elastography, also called point radiation force impulse, two-dimensional shear-wave elastography imaging, transient elastography (TE) (FibroScan®), and MR elastography, have become essential tools in the assessment of chronic stiffness in chronic liver diseases in children and adults, including FALD 21 . Compared with healthy controls, children and adults with Fontan-type surgery universally present increased values of LS, similar to advanced disease stages for no congestive etiologies, as in our cohort 22 , 23 . Even so, the interpretation of its results must be careful owing to its low specificity, since the vascular congestion of FALD itself may indicate greater hepatic stiffness and overestimate the degree of hepatic fibrosis, as occurs in our patients 24 . With respect to the hemodynamic assessment of hepatic pressures and their gradient, although we detected an elevation in both free and wedge pressures, this elevation was due to retrograde vascular congestion following Fontan surgery 25 . Therefore, the differential gradient is minimally elevated and correlates less with the degree of fibrosis than with hepatic congestion. With respect to the presence of esophageal varices as a sign of portal hypertension, the prevalence in children is lower than that in adults in various studies 26 . However, in our study, a greater number of patients presented with esophageal varices, probably due to the time elapsed since Fontan surgery, although no greater degree of severity was found. Furthermore, no correlation could be found between the presence or severity of the varices and a greater degree of hepatic fibrosis. This study has several limitations: the relatively small sample size and the single-center nature of the study may limit the generalizability of the results. However, because FALD is a rare condition and our hospital is a national referral center, the sample can be considered representative. On the other hand, this was a retrospective study based on data collected from medical records. This may be subject to information bias and a lack of standardization in the collection of some variables, as well as in the timing of data collection. Additionally, this retrospective study lacked systematic data on emerging fibrosis markers (with pediatric reference ranges remaining undefined). One of the major strengths of this study is its single-center design, which ensures uniformity in surgical procedures, follow-up intervals, and ultrasonographic techniques. The single-center design ensured that consistent procedures and imaging protocols were used. Finally, transjugular liver biopsy (TJLB) is a safe and effective technique for evaluating liver fibrosis in patients with Fontan physiology. It also allows for the simultaneous measurement of the hepatic venous pressure gradient and upper gastrointestinal endoscopy. In our series, technical and histological success was achieved in all patients, without relevant complications. On the other hand, the noninvasive methods used, such as liver elastography, liver function tests, and ultrasound parameters, did not significantly correlate with the degree of fibrosis in the biopsy, which calls into question their reliability in this population. Standardization of post-Fontan liver follow-up and the development of validated noninvasive markers are needed to identify patients at risk of liver progression. Multicenter collaboration and longitudinal follow-up are key to establishing effective screening and management protocols. Abbreviations The following abbreviations are used in this manuscript: Alb Albumin ALT Alanine aminotransferase APRI Aspartate aminotransferase-to-platelet ratio index AST Aspartate transaminase BNP B-type natriuretic peptide CH Congestive hepatopathy (CH) CHD Congenital heart disease CHFS Congestive Hepatic Fibrosis Score FALD: Fontan-Associated Liver Disease Fib-4 Fibrosis-4 LF Liver fibrosis LS Liver stiffness n.s. Not significant PHTN: portal hypertension Plt Platelet TJLB transjugular liver biopsy γ-GTP Gamma‒Glutamyl transferase HCC Hepatocellular carcinoma Declarations Funding Source: This study did not receive external funding. Author Contribution R.DA.P, C.S.S., M.T.H. wrote the main manuscript test and prepared figuresC.M.C, F.B.T, N.G.V., D.R.R., M.A.T., MI. T.C. : reviewd the manuscript References Hilscher MB, Johnson JN (2025) Fontan-Associated Liver Disease. Semin Liver Dis 45:114–128 Gordon-Walker TT, Bove K, Veldtman G (2019) Fontan-associated liver disease: a review. 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Physical examination and blood analysis findings in FALD patients Number of patients (n) Non normal ( %) Average value ( range ) Hepatomegaly (cm) 26 57% 2.8 ± 1.5 cm (1-6 cm) Splenomegaly (cm) 26 11.5% 4 ±1.5 cm (3-6 cm) Platelets (< 150,000) 26 39% 173.000 ± 50.000 (74.000-187.000) ALT 26 35% 31 17 IU/dl (9-87) AST 25 1% 30 ± 10.23 IU/dl (26 -62) GGT 24 46% 65 ± 0.8 IU/dl (15-184) Total proteins 24 0,4% 6,9 ± 41.5 mg/dl (4-8.2) Albumin 25 0,4% 4,5 ± 0,5 mg/dl (2.9- 5.3) Pro-BNP 18 11% 1611 ± 6200 pg/ml (57-26532) Alpha-fetoprotein 6 16% 3 ± 1.6 mg/dl (2.1-6.4) FIB-4 26 0% 0,6 ± 0.4 mg/dl (0.1-1.35) APRI test AST/platelets 25 0% 0.2 ± 0.1 mg/dl (0.08- 0.4) Table 2. Imaging findings in patients with Fontan liver disease at the time of tranjugular liver biopsy Number of test (n) Findings % patients Abdominal ultrasound 28 Normal Homogeneous hepatomegaly Heterogeneity hepatomegaly Liver nodules Splenomegaly 1% 57% 25% 7% 57% Liver doppler 28 Normal Flow reversal Increase in IR Mono-biphasic flow 36% 3,6% 11% 25% Elastography 28 Fibrosis F1 Fibrosis F2 Fibrosis F3 Fibrosis F4 0 21% 16% 63% Liver biopsy METAVIR 28 Fibrosis F1 Fibrosis F2 Fibrosis F3 Fibrosis F4 Sinusoidal dilation Perisinusoidal fibrosis Fibrous bridges 25% 43% 21% 0 100% 86% 43% Table 3. Correlation of the degree of histological fibrosis with laboratory and imaging findings Table 4. Correlation between the degree of liver stiffness measured via elastography and fibrosis laboratory indices. Additional Declarations No competing interests reported. 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Materno Infantil. H.G.U. Gregorio Marañón","correspondingAuthor":false,"prefix":"","firstName":"María","middleName":"del Mar Tolín","lastName":"Hernani","suffix":""},{"id":565202598,"identity":"3d7fe735-dc1e-4025-977a-86f88c3b6eb8","order_by":2,"name":"Carmen Miranda Cid","email":"","orcid":"","institution":"H. Materno Infantil. H.G.U. Gregorio Marañón","correspondingAuthor":false,"prefix":"","firstName":"Carmen","middleName":"Miranda","lastName":"Cid","suffix":""},{"id":565202601,"identity":"fea1461e-e654-4817-8ef1-02a0aae5e571","order_by":3,"name":"Fernando Ballesteros Tejerizo","email":"","orcid":"","institution":"H.Materno infantil. H.G.U. Gregorio Marañón","correspondingAuthor":false,"prefix":"","firstName":"Fernando","middleName":"Ballesteros","lastName":"Tejerizo","suffix":""},{"id":565202603,"identity":"841ab8ef-1e4c-4679-8253-ecc6f3d5c8ef","order_by":4,"name":"Nuria Gil Villanueva","email":"","orcid":"","institution":"H.Materno infantil. H.G.U. 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1","display":"","copyAsset":false,"role":"figure","size":436853,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFollow-up and control center protocol for Fontan-associated liver disease\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8219296/v1/d8459b3f27c021a51f11da9a.png"},{"id":99406688,"identity":"8a782a80-d8c4-4928-9f26-de09cfdeb027","added_by":"auto","created_at":"2026-01-02 20:53:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1685550,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8219296/v1/33047cbb-3ca0-4127-b723-02f267898f43.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Transjugular liver biopsy in Fontan-associated liver disease in children: assessment of safety and diagnostic value compared with noninvasive techniques","fulltext":[{"header":"Introduction","content":"\u003cp\u003eFontan-associated liver disease (FALD) is a unique form of congestive hepatopathy (CH) that occurs in patients who have undergone Fontan palliation for functional single-ventricle congenital heart defects (CHDs). FALD represents a spectrum of disease, ranging from liver fibrosis to cardiac cirrhosis, portal hypertension (PHTN), and hepatocellular carcinoma (HCC) \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSince 1970, the palleative Fontan operation has allowed the survival of hundreds of patients with single-ventricle-type congenital heart diseases. The principle of intervention involves a surgical cavopulmonary connection, and the right heart takes over the functionality of the left side. Among other effects, systemic venous blood shows significant hemodynamic changes, including elevated central venous pressure and diminished cardiac output\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Improved surgical techniques and postoperative patient care have contributed to increased long-term survival rates among children who underwent surgery after 2001, with a 10-year 95% survival rate \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. New Fontan physiology causes changes in other systems, such as the liver, intestine, pulmonary system or brain, whose pathophysiology remains unknown.\u003c/p\u003e \u003cp\u003eFontan-associated liver disease (FALD) represents a broad spectrum of liver dysfunctions ranging from mild fibrosis to established cirrhosis and has been identified in up to 80% of patients after Fontan \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Patients with underlying FALD also show a wide spectrum of manifestations over the years: asymptomatic initial liver congestion and sinusoidal dilation, fibrosis without portal hypertension (with possible regenerative nodules), advanced fibrosis with compensated/decompensated cirrhosis and portal hypertension (with eventual focal nodular hyperplasia, hepatocellular carcinoma, ascites, bleeding from esophagogastric varices or hepatic encephalopathy)\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. A well-established risk factor is time since surgery (especially more than 10 years).\u003c/p\u003e \u003cp\u003eLaboratory and imaging abnormalities are common in the setting of FALD but do not strictly correlate with disease stage. Liver biopsy is a cornerstone in the diagnosis and staging of most liver diseases\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. To date, noninvasive methods that correlate with the histological evolution of FALD to establish liver damage early have been identified. Recent guidelines from the European Association for the Study of the Liver (EASL) recommend transjugular rather than percutaneous liver biopsy in patients with Fontan physiology because of decreased bleeding and the possibility of performing cardiac catheterization at the same time \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe aims of this study were to analyze the efficacy and safety of transjugular liver biopsy (TJLB) as a diagnostic option in pediatric patients undergoing the Fontan procedure ten years after the procedure and to compare the liver biopsy findings obtained from this biopsy with those of other diagnostic and imaging tests to predict the evolution of FALD.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA retrospective, single-center, cross-sectional study was performed using a pseudonymized review of Fontan patients under 18 years of age recruited from a large center specializing in pediatric congenital heart disease and followed at the Pediatric Cardiology Service and Gastroenterology, Hepatology, and Nutrition Unit of the Gregorio Mara\u0026ntilde;\u0026oacute;n Maternal and Child Hospital in Madrid who underwent transjugular liver biopsy between 2019 and 2024.\u003c/p\u003e \u003cp\u003eThe inclusion criteria were as follows: age under 18 years, a history of operations involving the creation of Fontan circulation, ability to provide informed consent, stable clinical condition during evaluation, and liver sonoelastography, performed in conjunction with a panel of laboratory tests within the last six months from transjugular liver biopsies. The exclusion criteria were acute clinical deterioration during evaluation, conditions requiring immediate surgical or interventional treatment, pregnancy, a positive test result for hepatitis B surface antigen (HBsAg), a positive test result for hepatitis C virus antibodies, a past diagnosis of hepatitis B or C, autoimmune diseases causing chronic liver damage, and severe ascites preventing reliable liver stiffness (LS) assessment via ultrasound. Before the procedures, all patients underwent upper digestive endoscopy to identify varicose lesions secondary to possible portal hypertension.\u003c/p\u003e \u003cp\u003eAll patients included underwent transjugular liver biopsy (TJLB) via a standard technique with Seldinger access to the right internal jugular vein. A 38.5-cm long 10-French (sheath was advanced over a 0.035-inch guidewire into the IVC. A 6-F catheter was then used to select the right hepatic vein for portal manometry, including wedged and free pressure. Next, the catheter was exchanged for the 7-F stiffened cannula, which was advanced through the sheath and positioned in the right hepatic vein. A 19-gauge biopsy needle with a 20-mm tray was then advanced through the hepatic vein wall into the hepatic parenchyma under fluoroscopic guidance. For TJLB, the attainment of at least one core was considered adequate tissue sampling. Adequate biopsy samples were defined as the presence of \u0026ge;\u0026thinsp;11 portal tracts. Liver histological data were obtained from the pathology reports following review by experienced histopathologists. Fibrosis was staged according to the congestive hepatic fibrosis score (CHFS) staging system\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAfter the procedure, all the patients were observed, and vital signs were monitored for at least 4 hours. No heparin was administered during the biopsy segment of the procedure. Biopsies were not performed for patients whose international normalized ratio (INR) was greater than or equal to 3.0 or whose platelet count was less than 50000.\u003c/p\u003e \u003cp\u003eThe study also involved a retrospective analysis of data obtained from routine diagnostics of Fontan patients at our center. The following variables were collected from medical records: type of Fontan surgery; laboratory tests, such as complete blood count, platelet count, liver enzymes, and APRI calculation; coagulation status; viral hepatic serological panels; medications received; endoscopic studies; and ultrasound‒Doppler and elastographic studies performed by experienced operators closer to TJLB for less than 6 months. Fibrosis was staged according to the congestive hepatic fibrosis score (CHFS) staging system. The severity of liver stiffness (LS) was assessed via the METAVIR scoring system (F1\u0026ndash;F4), with F3 and F4 categorized as severe Fontan-associated liver disease (FALD). In addition, noninvasive liver state indices were calculated via laboratory test results and published formulas for parameters such as the AST/ALT ratio, APRI, FIB-4, and GGT/ALT. The APRI was calculated as (AST/30 of AST) \u0026times; 100/platelet count (10⁹/l), and FIB-4 was calculated as (age \u0026times; AST)/(platelet count (10⁹/l) \u0026times; \u0026radic;ALT) \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe data were analyzed via SPSS V.29 software. Descriptive statistics were used to assess differences in the characteristics of the study population. Continuous variables are presented as the means (standard deviations) or medians (interquartile ranges [IQRs]), whereas qualitative data are summarized as counts and percentages. The Mann‒Whitney U test was used to assess the strength of relationships between nonnormally distributed values. The independent samples median test was used to evaluate whether two separate groups differed in central tendency. The independent samples t test was used to compare continuous variables with a normal distribution. A p value of less than 0.05 was considered statistically significant. Factors associated with the degree of fibrosis histology were evaluated via linear regression analysis, followed by multiple regression analysis employing the forced entry method for variables with a p value of less than 0.05 in the univariate model. Spearman\u0026rsquo;s rank correlation was also performed as a nonparametric sensitivity analysis to account for the small sample size and to confirm the reliability of the association.\u003c/p\u003e \u003cp\u003eThe study was approved by the Research Ethics Committee of Hospital General Universitario (H.G.U.) Gregorio Mara\u0026ntilde;\u0026oacute;n, Madrid, Spain, in accordance with the Declaration of Helsinki. All procedures were performed with informed consent within the framework of the current clinical protocol approved in 2019 (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 28 biopsies were performed between January 2019 and December 2024 in 26 patients with left congenital heart disease who underwent the Fontan procedure. Most of the Fontan procedures included were not fenestrated (30%) or used conduits (70%). The most prevalent anatomical diagnosis was Hypoplastic Left Heart Syndrome (HLHS) or Hypoplastic left heart complex in 50 %, double inlet right or left ventricle in 28,5 %, L-Transposition of the great arteries, D-Transposition of the great arteries and double outlet right or left ventricle in 18 %, tricuspid atresia, pulmonary atresia with intact ventricular septum in only 3,5 %. Eighty-one percent of the patients were from the Community of Madrid, and only 19% were from other regions of Spain. 75% were male. The mean age at the time of Fontan surgery was 5.5 \u0026plusmn; 1 year (range: 3.6\u0026ndash;8 years), that at the time of biopsy was 16.1 \u0026plusmn; 1.4 years (range: 12\u0026ndash;18 years), and the mean time since surgery was 10.6 \u0026plusmn; 1.5 years (range: 6.7\u0026ndash;13.7 years). With respect to their usual medications, 92% of patients were taking acetylsalicylic acid, 23% were taking sildenafil, 1% were taking beta-blockers, and anticoagulants were used.\u003c/p\u003e\n\u003cp\u003eOne hundred percent of the biopsies achieved technical and histological success, defined as obtaining 2\u0026ndash;3 liver tissue cores and a sample sufficient for accurate histopathological diagnosis. In one patient, access was gained through the left internal jugular vein, secondary to situs inversus. No patient presented with obstruction of the upper compartment, which would have prevented the use of a transjugular approach. Three procedure-related complications with spontaneous resolution were recorded: one minor encapsulated hepatic hematoma and two minors apical pneumothoraces following jugular vein cannulation. One patient died after heart transplantation more than two years after our study. No other liver or oncological complications were observed during follow-up.\u003c/p\u003e\n\u003cp\u003eIn terms of noninvasive blood analysis findings, thirty-five percent of patients presented elevated ALT (30.9 \u0026plusmn; 17.4 U/L, range 9\u0026ndash;87 U/L), and 39% presented with thrombocytopenia (\u0026lt;150,000 platelets/qL). The platelet-to-spleen ratio was 16.2 \u0026plusmn; 6.7 cm (range: 4.6\u0026ndash;27 cm). Only one patient had low levels of total protein and albumin. Alpha-fetoprotein testing was performed in six patients, with elevated levels found in only one patient (Table 1). No patient had blood glucose levels below normal. Immunoglobulin levels were normal in all patients. No patient had positive serology for hepatotropic viruses.\u003c/p\u003e\n\u003cp\u003eThe normal values used were as follows: ALT:\u0026nbsp;\u0026lt;\u0026nbsp;40 IU/dl; AST:\u0026nbsp;\u0026lt;\u0026nbsp;45\u0026nbsp;IU/dl; GGT:\u0026nbsp;\u0026lt;\u0026nbsp;60.\u0026nbsp;IU/dl; total protein: 6\u0026ndash;8.3 mg/dl; albumin: 3.5\u0026ndash;5 mg/d; alphafetoprotein: 2.1 mg/dl; Pro-BNP (for children aged 10\u0026ndash;18 years)\u0026nbsp;\u003csup\u003e11\u003c/sup\u003e:\u0026nbsp;\u0026lt;\u0026nbsp;300 pg/ml; FIB 4:\u0026nbsp;\u0026lt;1.3: AST/platelets: 0.5\u0026ndash;1.5.\u003c/p\u003e\n\u003cp\u003eThe findings from the imaging, ultrasound, Doppler and elastography tests are shown in Table 2. Fifty-seven percent of patients had ultrasound splenomegaly, with a mean value of 11.6 \u0026plusmn; 2.8 cm (8\u0026ndash;18 cm). During Doppler studies, no patients showed a decrease in portal velocity or an increase in the IP over 13.5. The mean elastography value was 13.25 \u0026plusmn; 4 kPa (7\u0026ndash;20 kPa), with the highest degree of fibrosis in more than 60% of patients.\u003c/p\u003e\n\u003cp\u003eIn the upper gastrointestinal endoscopy study performed prior to the transjugular liver biopsy procedure, 61% of patients presented with esophageal varices (25% grades I and 36% grade II). No grade III or IV varices or gastropathy were observed in any of the subjects. A total of 79% of patients underwent catheterization with hepatic hemodynamic evaluation by introducing a balloon catheter and measuring free and hepatic enclosure pressures, revealing increases in both pressures (13.7\u0026nbsp;\u0026plusmn;\u0026nbsp;4.5 (range: 5\u0026ndash;22) and 12.5\u0026nbsp;\u0026plusmn;\u0026nbsp;4.5 (range 4\u0026ndash;21) mm Hg, respectively) above normal values (minus 5 mm Hg) in 96.5% of patients but with a gradient hepatic pressure within normality in all of them (1.5\u0026nbsp;\u0026plusmn;\u0026nbsp;0.9 (range 1\u0026ndash;3) mm Hg)\u0026nbsp;as a representation of hepatic vascular congestion in these patients.\u003c/p\u003e\n\u003cp\u003eIn univariate and multivariate analyses of the histological fibrosis grade with different laboratory data, ultrasound data, elastography data, and activity indices, such as the AST/platelet ratio, platelet/splenomegaly ratio, and FIB4 index, no statistically significant correlations were detected. Table 3 shows the degree of correlation and statistical significance.\u003c/p\u003e\n\u003cp\u003eOn the other hand, the elastography data were correlated with activity indices, but no statistically significant correlation was found (Table 4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eImprovements in surgical techniques and perioperative management have increased the survival rate of patients who undergo Fontan procedures in childhood, reaching rates of 80% at 20 years. Consequently, complications in the long term have increased, with liver disease being one of the most relevant due to its impact on morbidity and mortality \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Liver disease in patients with Fontan physiology begins during childhood and is common. The spectrum of liver disease ranges from mild to moderate and is reliably detected only by liver biopsy; most of our patients are asymptomatic, except for those with hepatomegaly and weak liver enzyme disorders\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur hospital is a national referral center for congenital heart disease. Since 2010, we have treated more than 180 patients from various regions via the Fontan procedure. Our study is the first in pediatric patients after Fontan procedures in Spain. While some studies in adults include pediatric patients over 16 years of age \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e, few studies have focused on pediatric patients, such as ours\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAs has been reported, there is a high risk of developing cirrhosis and cholangiocarcinoma, even in the absence of cirrhosis. After 10 years of Fontan surgery, we developed a clinical protocol that begins early evaluation of these patients, starting 5 years post-surgery, using clinical, laboratory, and imaging biomarkers. If any of these markers are abnormal, histological examination via liver biopsy is indicated. In cases of minimal variation in biomarkers, histological follow-up will be performed starting at 10 years, as proposed by other groups\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eUntil a noninvasive study of liver pathology has been validated, liver biopsy will continue to be the gold standard for identifying and staging liver disease in children with Fontan physiology. Transjugular liver biopsy, as our study demonstrated, is considered an equally effective technique for histological evaluation in FALD as percutaneous biopsy is. Nevertheless, the percutaneous route is expected to be the most informative, especially when performed with ultrasound guidance, allowing for the selection of the most abnormal regions. While transjugular biopsy may introduce a sampling bias, as it preferentially samples the perivascular region, which may theoretically be more affected by venous congestion, the transjugular approach has some advantages; it provides additional endoscopic evaluation and liver hemodynamic data performed during cardiac catheterization. A recent cohort of percutaneous liver biopsies confirmed this population\u0026rsquo;s high risk of bleeding, with a 7.1% postprocedural hemorrhage rate compared with 3.2% reported with the transjugular route, and the control of bleeding was easier \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. In our study, we obtained 2\u0026ndash;3 liver tissue cores and a sample sufficient for accurate histopathological diagnosis via the TJVIA, which achieved technical and histological success. Three minor procedure-related complications with spontaneous resolution were recorded, two of which were related to jugular vein cannulation, and only one hepatic hematoma was encapsulated, like other series \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. No other complications were observed during the procedures or during the follow-up. Other alternatives have been described, such as transfemoral liver biopsy, which avoids passing a rigid cannula through the Fontan canal and the right pulmonary artery, which could cause arrhythmias or vascular damage\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eNoninvasive measures of liver health, including biochemical markers and ultrasound, should be used to guide consultation from specialists in hepatology and consider liver biopsy to define the extent of liver disease. To assess the progression of fibrosis early, Horie et al demonstrated that a fibrosis-4 index greater than 0.17, measured at 2 years post-Fontan, was a strong predictor for Fontan, which was associated with liver disease development 10 years later. In addition, FIB-4 could be considered a good predictor of disease progression in other chronic liver diseases\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. However, in our series, we were unable to demonstrate a significant correlation between elevated FIB4 levels and the degree of histological fibrosis ten years after Fontan surgery, probably because of the mild or moderate fibrosis levels obtained and the sample size of our cohort.\u003c/p\u003e \u003cp\u003eAlthough different laboratory biomarkers, such as the APRI, γ-GTP, or BNP, have been shown to be positively correlated with the progression of fibrosis in adult patients with FALD\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e, there are many limitations in confirming these correlations in the pediatric cohort with the histological findings of the TJLB. Even so, certain guidelines continue to consider serological and combined serum-clinical tests (aspartate aminotransferase-to-platelet ratio index [APRI], ELF, FIB-4, Forns index, and FibroTest\u0026reg;) used in other liver disease etiologies have modest discriminatory power to identify patients with severe fibrosis and congestive progression and cannot be routinely recommended for staging liver disease in children.\u003c/p\u003e \u003cp\u003eIn other words, the usefulness of different imaging techniques for predicting the progression of fibrosis in adults with FALD also varies. In abdominal imaging, typical findings include FALD, hepatomegaly, atrophy of the right lobe, and hypertrophy of the caudate and left lobes, which become more apparent as the duration of the Fontan circulation increases. However, most findings are unspecific, except for heterogeneous and irregular periphereal nodules \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn advanced fibrosis and cirrhosis, the liver becomes less compliant, and the hepatic veins are dilated. In our series, ultrasound revealed that hepatomegaly was the most frequent finding, with heterogeneous and peripheral nodules present in more than a quarter of the patients. Another frequent finding was significant splenomegaly (greater than 10 cm in diameter), which was observed in more than half of the patients. However, in our cohort, no significant correlation was demonstrated between these findings and the degree of histological fibrosis.\u003c/p\u003e \u003cp\u003eWith respect to the Doppler studies performed on our patients, most showed no significant or specific findings. Only a small number showed minor changes in flow, reversal or monophasic flow. Many of these findings are frequently observed in adults with chronic pathology, with only the lack of three-phase blood flow of hepatic veins being secondary to the loss of the atrial beat. In our series, none of these findings correlated significantly with a higher degree of histological fibrosis \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn recent decades, different liver elastography techniques, such as point shear-wave elastography, also called point radiation force impulse, two-dimensional shear-wave elastography imaging, transient elastography (TE) (FibroScan\u0026reg;), and MR elastography, have become essential tools in the assessment of chronic stiffness in chronic liver diseases in children and adults, including FALD\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. Compared with healthy controls, children and adults with Fontan-type surgery universally present increased values of LS, similar to advanced disease stages for no congestive etiologies, as in our cohort \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Even so, the interpretation of its results must be careful owing to its low specificity, since the vascular congestion of FALD itself may indicate greater hepatic stiffness and overestimate the degree of hepatic fibrosis, as occurs in our patients\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eWith respect to the hemodynamic assessment of hepatic pressures and their gradient, although we detected an elevation in both free and wedge pressures, this elevation was due to retrograde vascular congestion following Fontan surgery \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Therefore, the differential gradient is minimally elevated and correlates less with the degree of fibrosis than with hepatic congestion. With respect to the presence of esophageal varices as a sign of portal hypertension, the prevalence in children is lower than that in adults in various studies\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. However, in our study, a greater number of patients presented with esophageal varices, probably due to the time elapsed since Fontan surgery, although no greater degree of severity was found. Furthermore, no correlation could be found between the presence or severity of the varices and a greater degree of hepatic fibrosis.\u003c/p\u003e \u003cp\u003eThis study has several limitations: the relatively small sample size and the single-center nature of the study may limit the generalizability of the results. However, because FALD is a rare condition and our hospital is a national referral center, the sample can be considered representative.\u003c/p\u003e \u003cp\u003eOn the other hand, this was a retrospective study based on data collected from medical records. This may be subject to information bias and a lack of standardization in the collection of some variables, as well as in the timing of data collection. Additionally, this retrospective study lacked systematic data on emerging fibrosis markers (with pediatric reference ranges remaining undefined).\u003c/p\u003e \u003cp\u003eOne of the major strengths of this study is its single-center design, which ensures uniformity in surgical procedures, follow-up intervals, and ultrasonographic techniques. The single-center design ensured that consistent procedures and imaging protocols were used.\u003c/p\u003e \u003cp\u003eFinally, transjugular liver biopsy (TJLB) is a safe and effective technique for evaluating liver fibrosis in patients with Fontan physiology. It also allows for the simultaneous measurement of the hepatic venous pressure gradient and upper gastrointestinal endoscopy. In our series, technical and histological success was achieved in all patients, without relevant complications.\u003c/p\u003e \u003cp\u003eOn the other hand, the noninvasive methods used, such as liver elastography, liver function tests, and ultrasound parameters, did not significantly correlate with the degree of fibrosis in the biopsy, which calls into question their reliability in this population. Standardization of post-Fontan liver follow-up and the development of validated noninvasive markers are needed to identify patients at risk of liver progression. Multicenter collaboration and longitudinal follow-up are key to establishing effective screening and management protocols.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eThe following abbreviations are used in this manuscript:\u003c/p\u003e\n\u003cp\u003eAlb Albumin\u003c/p\u003e\n\u003cp\u003eALT Alanine aminotransferase\u003c/p\u003e\n\u003cp\u003eAPRI Aspartate aminotransferase-to-platelet ratio index\u003c/p\u003e\n\u003cp\u003eAST Aspartate transaminase\u003c/p\u003e\n\u003cp\u003eBNP B-type natriuretic peptide\u003c/p\u003e\n\u003cp\u003eCH Congestive hepatopathy (CH)\u003c/p\u003e\n\u003cp\u003eCHD Congenital heart disease\u003c/p\u003e\n\u003cp\u003eCHFS Congestive Hepatic Fibrosis Score\u003c/p\u003e\n\u003cp\u003eFALD: Fontan-Associated Liver Disease\u003c/p\u003e\n\u003cp\u003eFib-4 Fibrosis-4\u003c/p\u003e\n\u003cp\u003eLF Liver fibrosis\u003c/p\u003e\n\u003cp\u003eLS Liver stiffness\u003c/p\u003e\n\u003cp\u003en.s. Not significant\u003c/p\u003e\n\u003cp\u003ePHTN: portal hypertension\u003c/p\u003e\n\u003cp\u003ePlt Platelet\u003c/p\u003e\n\u003cp\u003eTJLB transjugular liver biopsy\u003c/p\u003e\n\u003cp\u003e\u0026gamma;-GTP Gamma‒Glutamyl transferase\u003c/p\u003e\n\u003cp\u003eHCC Hepatocellular carcinoma\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding Source:\u003c/h2\u003e \u003cp\u003eThis study did not receive external funding.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eR.DA.P, C.S.S., M.T.H. wrote the main manuscript test and prepared figuresC.M.C, F.B.T, N.G.V., D.R.R., M.A.T., MI. T.C. : reviewd the manuscript\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHilscher MB, Johnson JN (2025) Fontan-Associated Liver Disease. 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Eur J Pediatr 181(1):159\u0026ndash;169. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00431-021-04163-3\u003c/span\u003e\u003cspan address=\"10.1007/s00431-021-04163-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRazavi J, Trout AT, Morin CE, Opotowsky AR, Smith CR et al (2025) Liver stiffness measured by MR elastography in children and adults with Fontan circulation: defining expected values and clinical associations. Pediatr Radiol. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00247-025-06366-4\u003c/span\u003e\u003cspan address=\"10.1007/s00247-025-06366-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen B, Schreiber RA, Human DG, Potts JE, Guttman OR (2016) Assessment of liver stiffness in pediatric Fontan patients using transient elastography. Can J Gastroenterol Hepatol 2016:7125193. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1155/2016/71251939\u003c/span\u003e\u003cspan address=\"10.1155/2016/71251939\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eH, Tanoue S, Mawatari S et al (2025) 04,. (June Fontan-Associated Liver Disease: Predictors of Elevated Liver Stiffness and the Role of Transient Elastography in Long-Term Follow-Up. Cureus 17(6): e85336. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.85336\u003c/span\u003e\u003cspan address=\"10.7759/cureus.85336\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e-Gill M, Mudaliar S, Prince D, Ni Than N, Cordina R, Majumdar A (2023) Poor correlation of 2D shear wave elastography andtransient elastography in Fontan-associated liver disease: A head-to-head comparison. JGH Open: open access J Gastroenterol Hepatol 7:690\u0026ndash;697\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReed RC, Yeh M, Files MD, Price J, Ahmed H et al (2025) Validation of Congestive Hepatic Fibrosis Score in Pediatric and Adult Fontan-Associated Liver Disease. Am J Surg Pathol 49:942\u0026ndash;947\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAgnoletti G, Ferraro G, Bordese R, Marini D, Gala S, Bergamasco L et al (2016) Fontan circulation causes early, severe liver damage. Should we offer patients a tailored strategy? Int J Cardiol 209:60\u0026ndash;65. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijcard.2016.02.041\u003c/span\u003e\u003cspan address=\"10.1016/j.ijcard.2016.02.041\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Physical examination and blood analysis findings in FALD patients\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of patients (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003enormal\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(\u003c/strong\u003e\u003cstrong\u003e%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(\u003c/strong\u003e\u003cstrong\u003erange\u003c/strong\u003e\u003cstrong\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHepatomegaly\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(cm)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e57%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e2.8\u0026nbsp;\u0026plusmn;\u0026nbsp;1.5\u0026nbsp;cm\u0026nbsp;(1-6\u0026nbsp;cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSplenomegaly\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(cm)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e11.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e4 \u0026plusmn;1.5 cm (3-6 cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlatelets\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(\u0026lt;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e150,000)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e39%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e173.000 \u0026plusmn; 50.000\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(74.000-187.000)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eALT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e31 17 IU/dl\u0026nbsp;(9-87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAST\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e30 \u0026plusmn; 10.23 IU/dl (26 -62)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGGT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e46%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e65 \u0026plusmn; 0.8 IU/dl (15-184)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal proteins\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u0026nbsp;0,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e6,9 \u0026plusmn; 41.5 mg/dl (4-8.2)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlbumin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u0026nbsp; 0,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e4,5 \u0026plusmn; 0,5 mg/dl (2.9- 5.3)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePro-BNP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e1611\u0026nbsp;\u0026plusmn;\u0026nbsp;6200 pg/ml\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(57-26532)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlpha-fetoprotein\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e16%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e3 \u0026plusmn; 1.6 mg/dl\u0026nbsp;(2.1-6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFIB-4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e0,6 \u0026plusmn;\u0026nbsp;0.4 mg/dl\u0026nbsp;(0.1-1.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAPRI test\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAST/platelets\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 225px;\"\u003e\n \u003cp\u003e0.2 \u0026plusmn; 0.1 mg/dl (0.08- 0.4)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Imaging findings in patients with Fontan liver disease at the time of tranjugular liver biopsy\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"557\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of test (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFindings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e% patients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbdominal ultrasound\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHomogeneous hepatomegaly\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHeterogeneity hepatomegaly\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eLiver nodules\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSplenomegaly\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003cp\u003e57%\u003c/p\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003cp\u003e57%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiver doppler\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFlow reversal\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eIncrease in IR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMono-biphasic flow\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36%\u003c/p\u003e\n \u003cp\u003e3,6%\u003c/p\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eElastography\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;16%\u003c/p\u003e\n \u003cp\u003e63%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiver biopsy\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMETAVIR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrosis F4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSinusoidal dilation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePerisinusoidal fibrosis\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFibrous bridges\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003cp\u003e86%\u003c/p\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Correlation of the degree of histological fibrosis with laboratory and imaging findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"666\" height=\"545\" 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alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Correlation between the degree of liver stiffness measured via elastography and fibrosis laboratory indices.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"635\" height=\"197\" 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children","lastPublishedDoi":"10.21203/rs.3.rs-8219296/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8219296/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eTo evaluate transjugular liver biopsy (TJLB) as a safe and effective diagnostic option in pediatric patients with liver disease secondary to Fontan surgery and to compare the histological results with those of noninvasive diagnostic tests in relation to the degree of liver fibrosis (LF).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective, single-center study of children under 18 years, Fontan surgery, underwent TJLB from 2019 to the present. Sociodemographic variables, type of heart disease, age at surgery, laboratory test results, ultrasound and liver elastography results, time to TJLB, hemodynamic study results, and degree of LF were collected.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFrom 2019 to 2024, 28 TJLBs were performed on 26 patients: 75% male. The mean age at surgery was 5.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1 year (range: 3.6\u0026ndash;8 years). The mean age at the time of biopsy was 16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 years (12\u0026ndash;18 years). Ninety-three percent of patients were receiving antiplatelet therapy. Upper gastrointestinal endoscopy showed 36% grade II esophageal varices and 25% grade I. All patients underwent catheterization and hemodynamic evaluation after the procedure. Thirty-nine percent had platelets less than 150,000, and 35% ALT elevated (30.9\u0026thinsp;\u0026plusmn;\u0026thinsp;17.4 IU/L, range 9\u0026ndash;87 IU/L). Six patients had alpha-fetoprotein levels, all in normal range. Ultrasonography revealed normal results in three patients (11%), 57% homogeneous hepatomegaly, 25% parenchymal heterogeneity, and 7% liver nodules. Fifty-seven percent showed ultrasound-guided splenomegaly (11.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8 cm (range: 8\u0026ndash;18 cm)), with a platelet-to-spleen ratio of 16.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7 (range: 4.6\u0026ndash;2.7). Normal liver doppler in 36%; only two patients experienced portal flow reversal, and one increased portal vein. Elastography performed in 68% of patients: F4 METAVIR fibrosis in 63% and F2-F3 fibrosis in 37% (13.25\u0026thinsp;\u0026plusmn;\u0026thinsp;4 kPa; range: 7\u0026ndash;20 kPa). No significant differences between liver-free pressure and wedge pressure. Liver biopsies revealed grade 4 fibrosis in only 21.4%, and 64% grade 2 or 3 fibrosis. The most frequent histological involvement was sinusoidal dilatation with perisinusoidal fibrosis (86%), associated with centrocentral fibrous bridges in 43%. There was only one complication after TJLB: a mild encapsulated hepatic hematoma autocontrolled and two mild pneumothoraces after jugular vein cannulation. In the comparative study, the histological grade of LF did not correlate statistically significantly with other noninvasive indices.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eTJLB is a safe and effective technique, performed concurrently with procedures such as gastrointestinal endoscopy and catheterization, with a low complication rate. In our series, the degree of fibrosis measured by elastography overestimated the degree of fibrosis measured by histological study.\u003c/p\u003e","manuscriptTitle":"Transjugular liver biopsy in Fontan-associated liver disease in children: assessment of safety and diagnostic value compared with noninvasive techniques","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-30 09:57:05","doi":"10.21203/rs.3.rs-8219296/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5a47c61c-1d1c-424e-a106-682bce4705a9","owner":[],"postedDate":"December 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-02T20:53:43+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-30 09:57:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8219296","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8219296","identity":"rs-8219296","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}