{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T20:11:57Z","timestamp":1785183117636,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop and validate a nomogram based on dynamic liver function indexes for predicting native liver survival (NLS) in children with biliary atresia (BA) at 2 years post-Kasai surgery, providing clinicians with a basis for individualized treatment decisions and optimizing early intervention strategies for high-risk children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children with type III BA were categorized by their 2-year NLS status. Univariate and multivariate logistic regression analyses were performed to identify predictors of NLS and to construct a nomogram model. Model performance was evaluated using internal bootstrap validation (1,000 resamples) and a training\u2013test split (7:3), with discrimination assessed by the area under the receiver operating characteristic curve (AUC) and calibration by calibration curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 134 children with type III BA were included. Univariate analysis identified significant associations between prognosis and the following: age at surgery, jaundice clearance failure, liver fibrosis stage, and 3-month postoperative levels of gamma-glutamyl transpeptidase (GGT), serum albumin (ALB), and aspartate aminotransferase and platelet ratio index (APRI) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Multivariate analysis established these independent predictors: liver fibrosis stage F4 (OR\u2009=\u20093.418, 95% CI: 1.745\u20136.695), APRI at 3 months (OR\u2009=\u20092.285, 95% CI: 1.175\u20134.445), age at surgery (OR\u2009=\u20091.773, 95% CI: 1.192\u20132.637), GGT at 3 months (OR\u2009=\u20091.942, 95% CI: 1.211\u20133.117), ALB at 3 months (OR\u2009=\u20090.948, 95% CI: 0.916\u20130.981), and jaundice clearance failure (OR\u2009=\u20092.437, 95% CI: 1.275\u20134.657). The resulting nomogram demonstrated stable performance across age subgroups (AUC\u2009=\u20090.926 for \u226460 days; AUC\u2009=\u20090.867 for &amp;gt;60 days). In the training set, the AUC was 0.872 (95% CI: 0.813\u20130.931), with sensitivity of 90.7% and specificity of 78.8%. The model showed excellent generalizability in the independent test set (AUC\u2009=\u20090.971).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study developed and validated a nomogram integrating dynamic liver function indicators, effectively predicting 2-year NLS in children with BA. The model provides a reliable quantitative basis for individualized treatment decisions and early intervention, with strong clinical applicability, particularly in resource-limited settings. It offers a foundation for optimizing early intervention strategies for high-risk children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1636257","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T06:55:37Z","timestamp":1772088937000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of a nomogram for predicting 2-year native liver survival in biliary atresia using dynamic liver function indicators"],"prefix":"10.3389","volume":"14","author":[{"given":"Bingliang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neonatal Surgery, Shanxi Medical University Affiliated Children\u2019s Hospital","place":["Taiyuan, China"]},{"name":"Department of Pediatrics, Shanxi Medical University","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Neonatal Surgery, Shanxi Medical University Affiliated Children\u2019s Hospital","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.1016\/S0140-6736(09)60946-6","article-title":"Biliary atresia","volume":"374","author":"Hartley","year":"2009","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s41572-024-00533-x","article-title":"Biliary atresia. 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