Rainbow Children's Hospital performs first Pediatric ABO Incompatible Renal Transplant on 16-year-old girl

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The transplantation was performed by a team of experts including Dr N Prahlad, Senior Consultant - Pediatric Nephrology, Dr. Balaraman, Senior Consultant - Pediatric Nephrology, Dr Moorthy G, Senior Consultant - Pediatric Surgery and Urology, Dr Arun Kumar, Senior Consultant - General Surgery and Urology and Dr. Muthu Veeramani, Sr. Urologist & Transplant Surgeon along with an Anesthetist and the Nursing Team.

Speaking about the Transplantation, Dr Prahlad said, "A 16-year-old girl visited the hospital along with her parents in December 2022 with severe anaemia, weight loss and height not appropriate to her age. She was also suffering from hurried breathing, acidosis and very low haemoglobin as well. Ultrasound done showed that both kidneys were small in size confirming that she was suffering from Chronic Kidney Disease. We stabilised her and started on hemodialysis.

The child became stable in 4 to 5 days. However, this was just a temporary solution. She was continued on maintenance dialysis which was done thrice a week with each session lasting for four hours. Maintenance dialysis is not only a continuous recurring expense but also has a major effect on the child's psychology as she needs to come hospital thrice a week and miss school. So we explained the situation to her parents and suggested that renal transplantation is great option for their child. Parents agreed for the same."

Dr Prahlad further said, "While her parents were willing to donate their kidney, the blood group of the child was O positive and her mother was B positive. Being an ABO incompatible, the renal transplantation becomes a higher risk. Most of the hospitals do not take the risk of performing this as the chances of rejection is high, especially in children. Special dialysis equipment's are needed for such surgery on children which are available at Rainbow Children's Hospital."

Talking about the procedure, Dr Prahlad explained, "To ensure that the mismatch does not happen, certain medicines were given & specialised dialysis was done 3 to 4 days before the transplantation. But with the facilities available and the experienced team at Rainbow Children's Hospital this surgery was performed successfully.

Kidney of the mother was taken out laparoscopically and was then transplanted to the child. The whole surgery was completed in three hours. Post-transplant child was on immunosuppression treatment. The child has gained 2cms height, 3 kg weight on follow up and has normal renal function."

Dr Balaraman reiterated that although renal transplantation is a well-known and successful treatment in adults, it's not being utilised to its potential in pediatric patients with CKD. He also said that such high-risk blood group incompatible transplantation is not done routinely in children and good team in a hospital with all infrastructure is the Corner stone for many successful renal transplants, like this.

Dr Prahlad said that this successful Renal transplantation is a therapy that gives a new lease of life to the child. It is the future for children with Chronic Kidney Disease (CKD), and that blood group incompatibility should not be a deterrent for kidney transplant. This will help more CKD children to have good quality life.

Mr. Saravanakumar Rajan, Vice President - Regional Operations, Rainbow Children's Hospital, Tamil Nadu, said, "At our hospital, we pride ourselves on having state-of-the-art infrastructure and facilities to perform critical kidney transplant surgeries. In addition, we have a dedicated transplant team who work together to ensure that each transplant surgery is a success. We also have a fully-equipped intensive care unit (ICU) with the latest monitoring and life support systems.

This is particularly important for kidney transplant patients, who may require close monitoring and support immediately after surgery. We also provide a range of support services, including counselling and education, to help our patients and their families through every step of the transplantation process."

Rainbow Children's Hospital, the leading chain of multi-speciality pediatric hospitals has been in the forefront to offer advanced pediatric care to children in need. With the advanced technology, state-of-the-infrastructure, team of experts and hospitals spread across the country offer tertiary and quaternary care including complex cardiac surgeries, neurosurgeries, pediatric liver transplants and pediatric bone marrow transplants along with pediatric renal transplants.

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