1. Provide Well-Balanced Nutrition
Biliary atresia is a condition that can be aided by good nutrition before and after the Kasai surgical procedure or liver transplant has been performed. In general, parents of these children need to give them balanced diets composed of three daily meals and additional small snacks. These children should be given more calories than others of the same age and size, as they have a quicker metabolism and thus burn calories at a faster rate than normal. The addition of MCT (medium-chain triglyceride) oil to formula and other foods will add calories to aid the child's growth. Young children too sick to take a bottle may need to be fed a high-calorie liquid diet through a nasogastric tube.
2. Monitor Child After Kasai Surgery
Following the Kasai procedure, the child's liver will likely function better than before but not completely normally. For effective management, the mother needs to continue to breastfeed if she did so prior to surgery or provide the child with a special formula containing certain fats that are more easily absorbed by the liver than others. The doctor is likely to suggest supplementing the child's nutrition with vitamins A, D, E and K, as these are fat soluble and cannot be digested without bile. Antibiotics may be prescribed directly after surgery and may need to be administered for several months to help guard against infection. Children suffering from biliary atresia are susceptible to liver and bile duct bacterial infections. Long-term management following Kasai surgery includes a bile acid replacement medicine, which aids bile flow. Blood tests and ultrasounds will be given at routine intervals to monitor liver functioning. Children with biliary atresia need to given the normal immunizations and vaccinations and should receive a yearly flu shot. Particularly important for these children are the vaccinations against hepatitis A and B.
3. Follow Specific Regimen Following Liver Transplant
Directly following a liver transplant and for the rest of his life, the biliary atresia patient will need to have very frequent laboratory tests, at least every three months. A strict regimen of medications must be administered for the first year following surgery. After the initial 12 months, at least one anti-rejection medication, generally tacrolimus, will need to be given daily. Parents need to follow the physician's after-care plan thoroughly to manage the condition effectively following the transplant. Long-term monitoring of the child's condition is necessary. Changes in the child's appetite and behavior necessitate an immediate visit to the doctor. Parents should also be aware of the most common signs of organ rejection, which include jaundice, fever and changes in urine and stool color and appearance.
