Breatnach CR, et al. – Here the authors presented the hypothesis that subclinical enteric protein loss might occur in patients post Fontan surgery. They found that subclinical protein loss was rare in asymptomatic children after Fontan procedure. Only 5% of patients had elevated stool alpha-1-antitrypsin with no other symptoms. Hence, further longitudinal follow-up studies were required to evaluate the ability of alpha-1-antitrypsin to provide earlier detection of protein-losing enteropathy in asymptomatic patients post Fontan.