Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation
ObjectiveTo clarify the early growth and developmental characteristics of children with biliary atresia (BA) undergoing primary liver transplantation (pLT).MethodsA prospective cohort study, which specifically focused on BA-pLT children, was conducted after the diagnosis of BA by following the child...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1198360/full |
| _version_ | 1797806312289992704 |
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| author | Heping Fang Zehao Li Ruoling Xian Yu Yin Juan Wang Hongling Guo Xiaoke Dai Mingman Zhang Yan Hu Yingcun Li |
| author_facet | Heping Fang Zehao Li Ruoling Xian Yu Yin Juan Wang Hongling Guo Xiaoke Dai Mingman Zhang Yan Hu Yingcun Li |
| author_sort | Heping Fang |
| collection | DOAJ |
| description | ObjectiveTo clarify the early growth and developmental characteristics of children with biliary atresia (BA) undergoing primary liver transplantation (pLT).MethodsA prospective cohort study, which specifically focused on BA-pLT children, was conducted after the diagnosis of BA by following the children at the time of pLT and 1, 3, 5, 7 months and 1 year after pLT for growth and developmental monitoring. The growth parameters were calculated according to the WHO standard, and the developmental status was assessed using Denver Developmental Screening Tests.ResultsA total of 48 BA children who received pLT at the age of 5.00 ± 0.94 months were analyzed. The weight-for-age Z-value (ZW) and length-for-age Z-value (ZL) were higher than the head circumference-for-age Z-value (ZHC) at pLT (P = 0.002 and 0.02), but they were all lower than the WHO growth standard (Z = 0) (P < 0.001). The ZW and ZHC decreased first and then returned to the population level at 1 year after pLT, while the ZL only returned to the preoperative status and was lower than the ZW and ZHC (P < 0.001). Developmental screening showed that 35% (17/48) of the children were defined as suspicious and 15% (7/48) were abnormal at 1–4 months after pLT, the most likely time to be suspected of developmental delay. At 1 year after pLT, gross motor skill delay still existed (12/45, 27%), and language skill delay began to appear (4/45, 9%).ConclusionsBA-pLT children suffer from growth and developmental problems. Low ZHC is the main growth problem before pLT, while low ZL is the problem after pLT. Developmental delays are significant after pLT, especially in motor and language skills. The current study suggested that further studies are warranted to clarify the long-term growth and developmental outcomes of BA-pLT children, to compare them with children undergoing the Kasai procedure and to explore their influencing factors and possible mechanisms. |
| first_indexed | 2024-03-13T06:05:26Z |
| format | Article |
| id | doaj.art-8bf9f2ce311d4ca797ad42478706b517 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-13T06:05:26Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-8bf9f2ce311d4ca797ad42478706b5172023-06-12T04:30:40ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-06-011110.3389/fped.2023.11983601198360Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantationHeping Fang0Zehao Li1Ruoling Xian2Yu Yin3Juan Wang4Hongling Guo5Xiaoke Dai6Mingman Zhang7Yan Hu8Yingcun Li9Department of Child Health Care, Children’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Child Health Care, Children’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Child Health Care, Children’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Child Health Care, Children’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Child Health Care, Children’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, ChinaObjectiveTo clarify the early growth and developmental characteristics of children with biliary atresia (BA) undergoing primary liver transplantation (pLT).MethodsA prospective cohort study, which specifically focused on BA-pLT children, was conducted after the diagnosis of BA by following the children at the time of pLT and 1, 3, 5, 7 months and 1 year after pLT for growth and developmental monitoring. The growth parameters were calculated according to the WHO standard, and the developmental status was assessed using Denver Developmental Screening Tests.ResultsA total of 48 BA children who received pLT at the age of 5.00 ± 0.94 months were analyzed. The weight-for-age Z-value (ZW) and length-for-age Z-value (ZL) were higher than the head circumference-for-age Z-value (ZHC) at pLT (P = 0.002 and 0.02), but they were all lower than the WHO growth standard (Z = 0) (P < 0.001). The ZW and ZHC decreased first and then returned to the population level at 1 year after pLT, while the ZL only returned to the preoperative status and was lower than the ZW and ZHC (P < 0.001). Developmental screening showed that 35% (17/48) of the children were defined as suspicious and 15% (7/48) were abnormal at 1–4 months after pLT, the most likely time to be suspected of developmental delay. At 1 year after pLT, gross motor skill delay still existed (12/45, 27%), and language skill delay began to appear (4/45, 9%).ConclusionsBA-pLT children suffer from growth and developmental problems. Low ZHC is the main growth problem before pLT, while low ZL is the problem after pLT. Developmental delays are significant after pLT, especially in motor and language skills. The current study suggested that further studies are warranted to clarify the long-term growth and developmental outcomes of BA-pLT children, to compare them with children undergoing the Kasai procedure and to explore their influencing factors and possible mechanisms.https://www.frontiersin.org/articles/10.3389/fped.2023.1198360/fullbiliary atresia (BA)primary liver transplantation (pLT)growth and developmentearly lifechildren |
| spellingShingle | Heping Fang Zehao Li Ruoling Xian Yu Yin Juan Wang Hongling Guo Xiaoke Dai Mingman Zhang Yan Hu Yingcun Li Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation Frontiers in Pediatrics biliary atresia (BA) primary liver transplantation (pLT) growth and development early life children |
| title | Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation |
| title_full | Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation |
| title_fullStr | Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation |
| title_full_unstemmed | Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation |
| title_short | Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation |
| title_sort | early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation |
| topic | biliary atresia (BA) primary liver transplantation (pLT) growth and development early life children |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1198360/full |
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