World Journal of Pediatric Surgery · Published 2026-03-16 · DOI 10.1136/wjps-2025-001156
In local hospitals with resource-limited regions lacking access to liver transplantation (LT) centers, it is important to detect early warning signs of liver damage and portal hypertension in jaundice-free biliary atresia (BA) survivors with native livers. Twenty-three blood samples and scorings from six BA survivors (Child-Pugh score 5 points) were evaluated using serum Mac-2 binding protein glycosylation isomer (M2BPGi) and aspartate aminotransferase to platelet ratio index (APRI) at a local hospital. The levels of M2BPGi and APRI were positively correlated (r=0.93, p<0.001), and these also correlated with liver biochemistry. In cases with signs of portal hypertension, such as varices and a dilatation of vein associated with portal vein, the levels of M2BPGi and APRI were significantly higher than in cases without these signs (p<0.001). High levels of M2BPGi and APRI suggest progressive liver damage and portal hypertension. In local hospitals with limited medical resources, evaluation using M2BPGi and APRI may be useful for the follow-up of jaundice-free BA survivors.
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