Biliary Atresia: A Case Report

Biliary Atresia (BA) is characterized by a progressive obliteration of all, or part of, the extrahepatic biliary tree. It is the primary indication for pediatric liver transplantation, responsible for approximately 50% of all pediatric liver transplants. The resting energy expenditure of children living with BA is 30-50% higher than that of healthy children of the same age because children with BA must consume additional calories to promote liver regeneration. BA prevents bile from traveling from the liver into the intestine, where it is crucial for fat absorption. Bile insufficiency in the intestine results in malnutrition, malabsorption, and fat-soluble vitamin (ADEK) deficiencies. Sixty to 80% of children with end-stage liver disease exhibit moderate to severe malnutrition before liver transplantation. By examining a child living with BA hospitalized at UNC-Hospitals, I explored the medical nutrition therapy for patients with BA before liver transplantation. According to the most recent research, the best nutritional treatment for BA patients before liver transplantation includes cycled EN nocturnal feeding with daily oral feeds using formula with a high MCT:LCT ratio. To prevent deficiencies, it is strongly recommended that BA patients be provided with 130-150% of the caloric DRI for age, 2.5-3 g/kg/d of protein, and ADEK supplements.Master of Public Healt