Abstract
Biliary atresia (BA) is a progressive neonatal bile duct disease treated with the Kasai procedure; however, complications may necessitate liver transplantation. We report a rare case of simultaneous hepatic artery and portal vein thrombosis in a term infant after Kasai surgery, leading to acute liver failure and urgent transplantation. Rapid deterioration with metabolic acidosis, hypovolemic shock, and coagulopathy suggested "liver infarction," confirmed by imaging, while thrombolysis failed to restore full viability. This case highlights the importance of recognizing vascular complications in BA and considering prophylactic anticoagulation to reduce risks. Three years posttransplantation, the patient remains stable.