A Technical Note on Portal Vein Reconstruction With Interposition Cadaveric Internal Iliac Vein Graft in an Infant With Biliary Atresia and Portal Vein Hypoplasia.

Kumudu S Solangaarachchi, Rohan Siriwardana, Suchintha B Tillakaratne, Meranthi Fernando, Aruna P Weerasuriya

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Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Kumudu S SolangaarachchiHepatobiliary Surgery, Colombo North Centre for Liver Diseases, Faculty of Medicine, University of Kelaniya, Ragama, LKA.

Rohan SiriwardanaHepatobiliary Surgery, Colombo North Centre for Liver Diseases, Faculty of Medicine, University of Kelaniya, Ragama, LKA.

Suchintha B TillakaratneHepatobiliary Surgery, Colombo North Centre for Liver Diseases, Faculty of Medicine, University of Kelaniya, Ragama, LKA.

Meranthi FernandoHepatobiliary Surgery, Colombo North Centre for Liver Diseases, Faculty of Medicine, University of Kelaniya, Ragama, LKA.

Aruna P WeerasuriyaProfessorial Surgical Unit, North Colombo Teaching Hospital, Ragama, LKA.

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No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Biliary atresia (BA) represents a major indication for pediatric liver transplantation worldwide. Portal vein (PV) hypoplasia often poses technical challenges during transplantation, as it may increase the likelihood of thrombosis or anastomotic complications. We present the case of a nine-month-old infant with BA and failed Kasai portoenterostomy who underwent living donor liver transplantation. Severe PV hypoplasia necessitated interposition grafting. A 2 cm cryopreserved cadaveric internal iliac vein was used, anastomosed proximally to the superior mesenteric-splenic confluence and distally to the graft PV using 7/0 interrupted polypropylene sutures. Intraoperative Doppler confirmed portal flow of 25 cm/s with triphasic hepatic venous outflow. This case demonstrates the technical feasibility of cadaveric internal iliac vein interposition for PV reconstruction in infant BA, expanding the options for managing PV hypoplasia in pediatric liver transplantation.

Indexed as

biliary atresiainternal iliac vein graftkasai portoenterostomypediatric liver transplantationportal vein hypoplasiaportal vein reconstruction

Identifiers

PMID41635387

DOI10.7759/cureus.100585

PMCPMC12862224

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