AUTHOR=Wang Ye , Zhang Pingping , Qi Ji , Guo Yanting 
  
TITLE=Growth in children with biliary atresia before and after liver transplantation: a retrospective analysis
  
JOURNAL=Frontiers in Pediatrics
  
VOLUME=Volume 13 - 2025
  
YEAR=2026
  
URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2025.1715315
  
DOI=10.3389/fped.2025.1715315
  
ISSN=2296-2360
  
ABSTRACT=BackgroundLittle is known about the long-term survival and growth outcomes of children following liver transplantation in China. Therefore, we investigated the long-term survival and growth status of children with biliary atresia (BA) before and after liver transplantation and attempted to identify specific influencing factors.MethodsWe included children who underwent liver transplantation for BA at Tianjin First Central Hospital between January 2014 and December 2018. Clinical data, indicators of liver function, growth data, and ascites status were collected for analysis from all patients. Postoperative complications were systematically assessed using a combination of clinical, laboratory, histological, and imaging evaluations. Complications were categorized and graded according to the Clavien–Dindo classification system.ResultsThis study included a total of 93 children under 2 years of age who underwent liver transplantation for BA. No significant increase in height was observed six months post-transplantation when compared to pre-transplantation (P = 0.126). A significant increase in the height-for-age Z-score occurred by year 2 (P = 0.001). Preoperative growth was negatively correlated with growth improvement at 2- and 5-years after transplantation (P < 0.001, r = −0.674 and r = −0.774, respectively). The occurrence of biliary complications was significantly associated with impaired catch-up growth post-transplantation (P = 0.008). The weight-for-age Z-score increased significantly over the first two years post-transplantation when compared with that before transplantation (P < 0.001); subsequently, this parameter plateaued and exhibited only minimal changes.ConclusionsGrowth retardation is common in children with BA prior to liver transplantation, with catch-up growth commencing six months post-surgery and peaking after two years. Children with more severe preoperative growth delays exhibited faster postoperative growth. Preoperative growth status exhibited only minimal impact on early liver function recovery post-transplantation.