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Updated: Jul 19, 2026
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Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
Hepatic changes in the failing Fontan circulation
Christoph H Kiesewetter1, Nick Sheron, Joseph J Vettukattill
1Southampton General Hospital, University Hospitals Southampton, Southampton, UK.
Heart (British Cardiac Society)
|September 29, 2006
Summary
Liver injury in Fontan circulation patients is linked to procedure duration and hepatic vein pressures. This study highlights CT scan utility and the prevalence of cardiac cirrhosis and associated risks.
Area of Science:
- Cardiology
- Hepatology
- Medical Imaging
Background:
- Failing Fontan circulation is a known cause of hepatic impairment.
- The specific nature of liver injury in these patients remains poorly understood.
Purpose of the Study:
- To correlate gross and histological liver changes in Fontan circulation patients with clinical, biochemical, and hemodynamic findings.
- To investigate the relationship between liver pathology and patient characteristics.
Main Methods:
- Retrospective assessment of 12 patients undergoing extracardiac Fontan conversion (2003-2005).
- Analysis of clinical, biochemical, hemodynamic data, CT scans, and liver histology.
- Correlation of liver changes with Fontan duration and hepatic vein pressures.
Main Results:
- Zonal liver enhancement on CT correlated with lower hepatic vein pressures and absence of cardiac cirrhosis.
- Gastro-oesophageal varices were more common with higher hepatic vein pressures and advanced cirrhosis.
- Cirrhosis extent, hepatic fibrosis, and broad scars positively correlated with hepatic vein pressure and Fontan duration.
- Protein-losing enteropathy was more frequent in patients with longer Fontan duration.
Conclusions:
- Liver injury in Fontan circulation is associated with Fontan duration and hepatic vein pressures.
- CT scans provide a non-invasive method for assessing liver changes.
- Cardiac cirrhosis is common, increasing risks for gastro-oesophageal varices and potentially hepatocellular carcinoma.
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