Elevation of Serum Galectin-3 and Liver Stiffness Measured by Transient Elastography in Biliary Atresia

Background and aim: Biliary atresia (BA) is an intractable neonatal liver disease characterized by progressive fibrosclerotic obliteration of the extrahepatic biliary tree. The aim of this study was to evaluate serum galectin-3 in postoperative BA patients and the association between galectin-3, clinical outcome and liver stiffness score. Methods: 58 BA patients post Kasai operation and 20 controls were enrolled. None of the patients had undergone liver transplantation. BA patients were classified into 2 groups according to their serum total bilirubin (TB) levels (TB < 2 mg/dL, no jaundice vs. TB >= 2 mg/dL, persistent jaundice) and alanine aminotransferase (ALT) levels (ALT < 45 IU/L, normal ALT vs. ALT >= 45 IU/L, elevated ALT). Serum galectin-3 levels were determined by enzyme-linked immunosorbent assay. Liver stiffness scores were measured by transient elastography (FibroScan). Results: BA patients had higher serum galectin-3 levels (5.1 +/- 0.3 vs. 3.8 +/- 0.4 ng/mL, p = 0.01) and greater liver stiffness values than healthy controls (29.7 +/- 3.0 vs. 5.1 +/- 0.5 kPa, p < 0.001). Serum galectin-3 levels were markedly elevated in BA patients with jaundice compared to those without jaundice (6.4 +/- 0.5 vs. 4.4 +/- 0.3 ng/mL, p = 0.001). Furthermore, BA patients with elevated ALT displayed significantly higher levels of serum galectin-3 than those with normal ALT (5.9 +/- 0.4 vs. 3.8 +/- 0.3 ng/mL, p = 0.001). Additionally, BA patients with portal hypertension had considerably higher serum galectin-3 levels than those without portal hypertension (6.1 +/- 0.4 vs. 3.7 +/- 0.3 ng/mL, p < 0.001). Conclusions: Increased serum galectin-3 is associated with a poor outcome in postoperative BA patients. Serum galectin-3 could be used as a biochemical parameter reflecting the deterioration of liver function and the severity of liver fibrosis in postoperative BA.