Review on engineering design of degradable smart materials for pediatric hepatobiliary tissue engineering and integrated therapeutic monitoring

Pediatric hepatobiliary diseases, especially congenital biliary malformations such as biliary atresia, are the main causes of liver failure and death in infants and young children. At present, traditional treatment methods and liver transplantation are facing severe challenges such as donor shortage, immune rejection and long-term complications. Tissue engineering technology provides a revolutionary solution for the regeneration and repair of pediatric hepatobiliary diseases. Among them, degradable intelligent materials, as the core of the scaffold, not only provide temporary mechanical support and cell growth microenvironment, but also synchronize with tissue regeneration through controllable degradation to avoid secondary surgical removal. More importantly, smart materials with integrated sensing functions can realize real-time monitoring of the treatment process, forming an integrated “treatment-monitoring” system. This review aims to summarize the research progress of degradable smart materials in the field of pediatric liver and biliary tissue engineering. The research scope is limited to pediatric liver and biliary diseases such as biliary atresia. The focus is on material engineering design, degradation regulation strategies, and the construction of a treatment-monitoring integrated system. This article compares the advantages and disadvantages of four types of degradable smart materials, analyzes the four engineering design principles of scaffold biomimetic structure, degradation kinetics, mechanical matching, and surface functionalization, and explains the workflow of the integrated monitoring system. The study concludes that the current field still faces multiple obstacles such as immune safety, long-term stability of sensing, individualized manufacturing, and standardization of clinical supervision; in the future, it is necessary to rely on multidisciplinary integration to promote material innovation, accelerate the transformation to pediatric clinical practice, and provide theoretical support for precise treatment of pediatric liver and biliary diseases. At the same time, this review deeply explores the construction methods of integrated treatment monitoring systems, covering biosensing mechanisms, signal transduction patterns, and data analysis algorithms. Finally, this review looks forward to the challenges faced by this field and the future development direction, so as to provide theoretical basis and technical support for accurate and personalized treatment of pediatric hepatobiliary diseases.