Assessing hepatic impairment in Fontan-associated liver disease using the HepQuant SHUNT test

Congenital Heart Disease
Alexander LemmerDaniel Ganger

Abstract

Fontan surgery for single ventricle congenital heart disease leads to Fontan-associated liver disease (FALD). Typical laboratory tests, imaging, and histopathology cannot predict clinical severity in FALD. HepQuant SHUNT is a proprietary serum test of hepatic function and physiology that has not yet been evaluated in FALD. Fourteen adult FALD patients at a single urban tertiary care center who underwent a Fontan procedure in childhood received HepQuant SHUNT testing between September 2015 and April 2018. The HepQuant SHUNT disease severity index (DSI) assesses global liver function and physiology from systemic and portal hepatic filtration rates (HFRs, clearances adjusted for body mass) of orally and intravenously administered cholates labeled with deuterium or 13C. The SHUNT parameter of the test measures portal systemic shunting from the ratio of Systemic HFR to Portal HFR. Chart review included laboratory tests, imaging, and clinical findings. Data from FALD patients were compared with data from healthy controls. The average DSI and SHUNT values for the FALD patients were 17.5% and 36.1%, respectively, compared to 9.2% and 24.1%, respectively, for controls. Twelve (85.7%) FALD patients had a DSI >15 (upper limit of normal). ...Continue Reading

References

Mar 11, 2008·The Journal of Thoracic and Cardiovascular Surgery·Mireen Friedrich-RustHashim Abdul-Khaliq
May 16, 2014·The Journal of Thoracic and Cardiovascular Surgery·Byung Won YooSeung Up Kim
Jun 25, 2014·World Journal for Pediatric & Congenital Heart Surgery·Josep Lluís Melero-FerrerJoaquín Rueda-Soriano
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Jun 11, 2016·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Michael L WellsSudhakar K Venkatesh
Apr 20, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Alexander LemmerDaniel Ganger

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Citations

Jan 6, 2021·Translational Research : the Journal of Laboratory and Clinical Medicine·James R BurtonGregory T Everson
Apr 8, 2021·Translational Research : the Journal of Laboratory and Clinical Medicine·T Tara Ghaziani, Paul Y Kwo

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