{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:46:55Z","timestamp":1787510815174,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The accuracy of liver biopsy to stage fibrosis due to Fontan\u2010associated liver disease (FALD) remains unclear. We compared the results of biopsy pre\u2013combined heart and liver transplantation (CHLT) to the results of whole liver explant. Liver biopsy and explants from 15 Fontan patients (ages 16\u201049, median 28\u00a0years) were retrospectively reviewed. Staging was as follows: stage 0: no fibrosis, stage 1: pericellular fibrosis, stage 2: bridging fibrosis, and stage 3: regenerative nodules. There is no stage 4. Clinical characteristics including Model of End\u2010stage Liver Disease eXcluding INR and Varices, Ascites, Splenomegaly, and Thrombocytopenia (VAST) scores were collected, and descriptive statistics and Mann\u2010Whitney\n                    <jats:italic>U<\/jats:italic>\n                    tests were used to analyze the data. All patients had biopsies with at least bridging fibrosis, and all had nodularity on explant; transjugular biopsy never overestimated fibrosis. Explant showed higher\u2010grade fibrosis (stage 3) than pre\u2010CHLT biopsy (stage 2) in 6 of 15 patients and equal grade of fibrosis (stage 3) in 9 of 15 patients. Though clinical characteristics varied significantly, VAST score was \u22652 in all but two patients. Transjugular liver biopsy does not overestimate and can underestimate fibrosis in Fontan patients undergoing CHLT, likely due to the patchy nature of fibrosis in FALD.\n                  <\/jats:p>","DOI":"10.1111\/ctr.14120","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T15:37:46Z","timestamp":1602689866000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Does liver biopsy accurately measure fibrosis in Fontan\u2010associated liver disease? A comparison of liver biopsy pre\u2013combined heart and liver transplant and liver explant post\u2010transplant"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-3548","authenticated-orcid":false,"given":"Sumeet S.","family":"Vaikunth","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Pathology Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldo","family":"Concepcion","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation Department of Surgery Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Haeffele","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Stanford University School of Medicine Palo Alto CA USA"},{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail E.","family":"Wright","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George K.","family":"Lui","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Stanford University School of Medicine Palo Alto CA USA"},{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tami","family":"Daugherty","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Stanford University School of Medicine Palo Alto CA 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Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14120","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.14120","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T15:37:35Z","timestamp":1693582655000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":20,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/ctr.14120"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14120","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]},"assertion":[{"value":"2020-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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