Home‑Based Nutritional Management After Pediatric Liver Transplantation: Dilemmas and Needs from Dual Perspectives

To explore the dilemmas and needs of home-based nutritional management for pediatric liver transplant recipients from the dual perspectives of caregivers and medical providers.

A descriptive qualitative study using traditional content analysis.

Using purposive sampling, semi-structured in-depth interviews were conducted from December 2025 to January 2026 with caregivers of pediatric LT recipients, as well as physicians, nurses, and dietitians from a tertiary hospital in Hangzhou. Traditional content analysis was employed for data analysis.

A total of 20 participants were enrolled (11 caregivers, 6 nurses, 2 physicians, and 1 dietitian). Four core themes were identified. Cognitive dilemmas included caregivers' superficial understanding of nutrition-rehabilitation associations, poor transmission of authoritative information, and misleading non-professional sources. Behavioral dilemmas comprised imbalance between risk avoidance and nutritional adequacy, lack of nutritional monitoring, and declining adherence. Structural dilemmas involved fragmentation of multidisciplinary collaboration, socioeconomic and family constraints, and disconnected out-of-hospital communication. Systematic support needs encompassed follow-up and monitoring, standardized nutritional training, and peer and social support.

Home nutritional management for pediatric LT recipients faces cognitive, behavioral, and structural dilemmas: caregivers show shallow knowledge, conservative practices, and poor adherence; systems suffer from fragmented teamwork, poor out of hospital communication, and socioeconomic barriers. Both sides desire smart platforms, diversified follow-up, standardized training, and social support. We recommend a hospital-home collaborative model integrating smart monitoring, phased follow-up, multidisciplinary cooperation, and social resources to enhance nutritional outcomes and quality of life.