By Joanne Salt-Hill
Four-year-old Kaden Ochoa had a rough start in life. He was born with a birth defect to his portal vein, known as extrahepatic portal vein obstruction, which caused him to suffer from internal bleeding, an enlarged spleen, stunted growth and poor liver function. After watching her son endure repeated endoscopies for more than two years to help control the bleeding his mother began her search for a better alternative. She found her solution at UTMB . . . by way of Chicago.
“He was born with the problem and has been struggling since birth,” said Claudia Ochoa, who lives in El Paso with Kaden and his 9-year-old sister, Natalie.  “It has been very difficult, with many trips to the doctor. I wanted to find a solution and began researching his condition on the Internet. I printed all the information I found and presented it to his doctors. I wanted to find someone who could help Kaden live a normal life.”
Ochoa found Dr. Riccardo Superina, a pediatric surgeon at Ann and Robert H. Lurie Children’s Hospital in Chicago, Ill., who specializes in a surgical procedure that uses a shunt to bypass the portal vein obstruction and restore full blood flow to the liver — a long-term solution to Kaden’s birth defect. But after contacting her insurance provider, she found that she would not be able to have the procedure done outside the state of Texas.
It was then that Kaden’s gastroenterologist referred Ochoa to UTMB pediatric surgeon Dr. Ravi Radhakrishnan, chief of UTMB pediatric surgery, who had mentored under Superina and had assisted him in performing the procedure many times in Chicago. Radhakrishnan contacted Superina and the two doctors agreed to team up and do the surgery — the first of its kind in Texas — at UTMB.
“The surgery went very well, we were able to bypass the obstruction and restore all the blood flow back to Kaden’s liver,” said Radhakrishnan. “Long term, I expect that he will do very well. His shunt is functioning and he is experiencing normal blood flow through the portal vein. This procedure takes care of many of the problems that are associated with his condition — within 6 months to a year the varices that were bleeding in his esophagus will collapse and get smaller; his spleen, which is quite large now, will slowly start to shrink back to normal size; his liver, which is a little bit smaller than normal, will expand to normal size; and he will experience a growth spurt over the next year that will put him where he should have been physically had he not had this condition. He will then be medication free and able to live a normal life.”
Claudia Ochoa, Kaden and Chief of UTMB Pediatric Surgery, Dr. Ravi Radhakrishnan are all smiles following Kaden’s successful surgery.Kaden underwent surgery in July and went home to El Paso following a short convalescence at the Ronald McDonald House and is expected to make a full recovery.
“It took a lot of time, dedication and research to find the right doctor who could help Kaden,” said Ochoa. “I feel good that it happened at UTMB and that the surgery was such a success. I am very thankful for Dr. Radhakrishnan for making the surgery possible in Texas and bringing Dr. Superina to UTMB to assist. It eased our struggle to have the surgery done here.”
Radhakrishnan is establishing UTMB as a center for treating conditions such as Kaden’s that are caused by pediatric portal hypertension and offers patients and their families a wide range of treatment options that include medications to treat bleeding, endoscopic procedures and specialized surgery.
UTMB Pediatric Surgery care and services range from routine procedures for appendicitis and hernia repairs to treatments for rare or complex conditions such as solid tumors, multiple congenital anomalies and complex hepatobiliary malformations.

Surgical photos by Steve Schuenke, UTMB.