The Liver Meeting 2023-Clinical Practice SIG: Clinical Practice Challenges

Video Transcription

Video Summary

Fontan-associated liver disease (FALD) affects patients who underwent the Fontan procedure for congenital heart disease. Liver biopsy confirms fibrosis and cirrhosis, suggesting potential need for liver transplant due to risks of progression to cirrhosis and liver cancer. Combined heart-liver transplants show better outcomes in FALD patients. Late referrals and advanced liver disease correlate with reduced post-transplant survival, emphasizing the importance of timely evaluation. Despite challenges, recent studies support combined transplants for better survival rates in this population. Discussions by experts underscored topics like the prevalence of FALD, benefits of combined transplants, and considerations for low-MELD score patients. Various aspects of liver disease management and transplantation were covered, including bariatric surgery, cirrhotic cardiomyopathy management, and endoscopy in follow-up care. These discussions shed light on the complexity of decision-making in treating liver diseases and the importance of a multidisciplinary approach.

Keywords

Fontan-associated liver disease

FALD

Fontan procedure

congenital heart disease

liver biopsy

fibrosis

cirrhosis

liver transplant

combined heart-liver transplant

post-transplant survival

late referrals

liver disease management

multidisciplinary approach