2023 Fiscal Year Final Research Report

Novel biomarker for Fontan associated liver dysfunction and its interaction with Fontan specific hemodynamics

Research Project

PDF

Project/Area Number	20K08191
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 52050:Embryonic medicine and pediatrics-related
Research Institution	Iwate Medical University
Principal Investigator	SAIKI HIROFUMI 岩手医科大学, 医学部, 准教授 (50813797)
Co-Investigator(Kenkyū-buntansha)	黒田英克岩手医科大学, 医学部, 特任教授 (70382596) 塩畑健岩手医科大学, 医学部, 助教 (60802410) 小山耕太郎岩手医科大学, 医学部, 教授 (80170398) 中野智岩手医科大学, 医学部, 講師 (40748638)
Project Period (FY)	2020-04-01 – 2024-03-31
Keywords	フォンタン循環 / フォンタン術後症候群 / フォンタン関連肝障害
Outline of Final Research Achievements	With increasing postoperative interval in patients with Fontan circulation, the ratio of hepatic venous oxygen saturation to inferior vena caval oxygen saturation (Sat HV/IVC) increased. In adult Fontan patients aged ＞ 16 years, a high Sat HV/IVC ratio was associated with liver fibrosis. It is also associated with Fontan-related complications. These findings supported our hypothesis that the increase in hepatic venous oxygen saturation reflected either a change in hepatic blood flow source from the portal vein to the hepatic artery or a decrease in hepatic vascular resistance. Interestingly, liver function, assessed by indocyanine green kinetics, improved with an increase in the Sat HV/IVC ratio, suggesting that the Sat HV/IVC ratio is a marker for the hepatic structural-functional uncoupling observed in patients with Fontan circulation. The clinical significance of the Sat HV/IVC ratio is needed to determine whether it can guide to prevent end-organ damage.
Free Research Field	小児循環器病学
Academic Significance and Societal Importance of the Research Achievements	フォンタン手術の周術期管理が改善し、フォンタン術後遠隔期合併症に苦慮する症例が増加している。主要な合併症であるフォンタン関連肝障害において、本研究で用いた方法、特に肝静脈酸素飽和度は肝予備能を維持・代償しながらもフォンタン関連肝障害が始まる初期病態を反映する可能性があり、予後指標・管理指針として、今後確立が期待される。