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Combined support met calorie and protein goals by week one, with infants showing higher adequacy than older children.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/nutrition-support-adequacy-in-children-with-biliary-atresia-after-liver-transplant/466920/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/nutrition-support-adequacy-in-children-with-biliary-atresia-after-liver-transplant/466920.png","ImageObject",300,407,{"name":42,"@type":43},"Ben ","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-09","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What outcome does the study assess in the first week after liver transplant?","Question",{"text":63,"@type":64},"The study evaluates nutrition adequacy, focusing specifically on energy and protein, during the first week of PICU admission.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was nutrition support adequacy measured?",{"text":68,"@type":64},"Nutrition adequacy was obtained for both enteral and parenteral nutrition support provided during the first week after transplant while patients were in the PICU.",{"name":70,"@type":61,"acceptedAnswer":71},"What difference did the results show between infants and older children?",{"text":72,"@type":64},"Infants achieved significantly higher nutrition adequacy than children older than one year during the first week for both calories and protein.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},466920,1790811758,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Article  \nNutrition Support Adequacy in Children with Biliary Atresia After Liver Transplant  \nNicole Knebusch 1,2,3, Manpreet Virk 1,2, Moreshwar S. Desai 1,2, Marwa Mansour 1,2, Stacey Beer 2,4, Brittany Pearo 5, Kelby Fuller 2,6, Krupa Mysore 2,4, John Goss 2,6, Thomas Fogarty 1,2, Fernando Stein 1,2 and Jorge A. Coss-Bu 1,2, *  \nAcademic Editor: Naoki Tanaka  \nReceived: 17 November 2025  \nRevised: 24 December 2025  \nAccepted: 29 December 2025  \nPublished: 31 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; [nknebusch@ufm.edu](nknebusch@ufm.edu) (N.K.)  \n2 Texas Children’s Hospital, Houston, TX 77030, USA  \n3 Imperial College of London, London SW7 2AZ, UK  \n4 Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA  \n5 Department of Clinical Nutrition Services, Texas Children’s Hospital, Houston, TX 77030, USA  \n6 Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA  \n* [Correspondence: jacossbu@texaschildrens.org](Correspondence: jacossbu@texaschildrens.org)  \nAbstract  \nBackground: The nutrition support of children with biliary atresia after liver transplant is affected by multiple factors, and a connection between these factors and conditions present before transplant can potentially make the nutrition support more challenging. We aim to assess the adequacy of nutrition support, specifically energy and protein, during the first week of admission to the Pediatric Intensive Care Unit (PICU) in children after liver transplant secondary to biliary atresia. Methods: We performed a retrospective cohort study of 138 patients [13.9 median (9–33.4) IQR months; 62% female] with a diagnosis ofbiliary atresia admitted to the PICU after liver transplantation at Texas Children’s Hospital over a 14-year study period. We obtained nutrition adequacy of enteral and parenteral nutrition support for the first week after transplant during their PICU admission. Results: Goal adequacy was reached at the end of the first week of admission when combined enteral and parenteral nutrition support was provided (median 98% for energy and 101% for protein) . Infants achieved significantly higher adequacies than older children during the first week (136% \u003C 1 year vs. 0% > 1 year, p \u003C 0.001 for calories, and 157% \u003C 1 year vs. 0% > 1 year for protein; p \u003C 0.01) . Conclusions: These findings highlight the complex nutritional challenges faced by this population, and strategies are needed to meet the unique needs of children after liver transplantation.  \nKeywords: pediatrics; nutrition support; intensive care; liver transplant; biliary atresia  \n1. Introduction  \nBiliary atresia (BA) is the most common cause of neonatal cholestasis. It is a progressive obstructive disease of the intrahepatic and extrahepatic biliary tree, accompanied by structural changes and fibrosis [1–3] . Biliary obstruction leads to severe cholestasis, rapid progression of fibrosis and subsequent cirrhosis and the need for a liver transplant [4] . It is a rare disease of early infancy with an unknown etiology, and an incidence of around 8000–18,000 live births worldwide [1,5] . Specific mechanisms have been proposed for the etiology of BA, including perinatal viral infection, toxin exposure, altered immune response, or abnormal bile duct development [1] .  \nSome of the common indications for liver transplant include inborn errors of metabolism, autoimmune diseases, and Wilson’s disease, with BA being the disease of interest in this research as the leading indication for liver transplant in children [5] .  \nOne of the indications for liver transplantation in children with BA is failure to thrive a","cbCaikR1ag7xz3Or","https://ap.wps.com/l/cbCaikR1ag7xz3Or","pdf",687264,14,"English","# Abstract\n# 1. Introduction","[{\"question\":\"What outcome does the study assess in the first week after liver transplant?\",\"answer\":\"The study evaluates nutrition adequacy, focusing specifically on energy and protein, during the first week of PICU admission.\"},{\"question\":\"How was nutrition support adequacy measured?\",\"answer\":\"Nutrition adequacy was obtained for both enteral and parenteral nutrition support provided during the first week after transplant while patients were in the PICU.\"},{\"question\":\"What difference did the results show between infants and older children?\",\"answer\":\"Infants achieved significantly higher nutrition adequacy than children older than one year during the first week for both calories and protein.\"}]","Nutrition Support Adequacy in Children with Biliary Atresia After Liver Transplant | PDF",1790772057,35]