eng Science and Education Publishing International Journal of Celiac Disease 2334-3486 2021-01-21 9 1 12 15 10.12691/ijcd-9-1-4 IJCD2021914 article Bhavin Vasavada drbhavin.liversurgeon@gmail.com 1 Consultant Hepatobiliary and Liver Transplant Surgeon, India Introduction: Biliary atresia is commonly associated with malnutrition and failure to thrive. Very few studies have been published on the impact of preoperative malnutrition on post-transplant outcomes in these children. Material and Methods: 110 children underwent living donor liver transplantation from January 2003 to March 2013. Pre-transplant malnutrition was defined according to z scores for the weight for age and height for age as per who definition. Patients having both Z score of < -2 were compared with the control group. Statistical analysis was done using SPSS version 21 (IBM). Results: 39 children out of 110 were having z score for the weight for age < -2. There was no statistical difference between PELD score, graft weight, GRWR, intraoperative blood loss between to groups. 22 out of 39 patients in malnourished group developed clavein grade 3, grade 4 complications and 32 patients out of 71 in the control group developed clavien grade 3 grade 4 complications. (p= 0.318). The overall mortality rate was 4.5% and mortality rates in the malnourished vs control group were respectively 7.69% and 2.81% (p= 0.278). A total of 14 patients developed postoperative pulmonary complications. Pulmonary complications were significantly high in the malnourished group. p=0.003. Conclusion: Preoperative malnutrition is associated with a high postoperative pulmonary complication rate in liver transplantation for biliary atresia. http://pubs.sciepub.com/ijcd/9/1/4/ijcd-9-1-4.pdf biliary atresia liver transplants pulmonary complication