Hyperplastic nodules, focal nodular hyperplasia, and HCC have been reported in patients post-Fontan, including children.17,18,29–31 Cirrhosis guidelines from the American Association for the Study of Liver Diseases recommend abdominal ultrasound and AFP determination every 6 months, and these guidelines should be followed until more FALD-specific data are available.32 This evidence concerns the gene AFP and liver disorder.