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Past events at MIOT

Kidney transplantation in small children less than 15 kilograms has lot of problems. Technically it becomes difficult to place adult kidney in such a small child. The blood vessels of the adult kidney are much larger and required to be anastamosed to the aorta or IVC in the child. There is a space constraint for an adult kidney in child’s abdomen The adult kidney also takes away almost 150ml of the blood from the child’s circulation, which can produce haemodynamic problems. Post operatively the management of very small child is also difficult. Medically rejection rates are more in children as compared to adults and they require relatively larger dose of drugs.

Master. S.Sanjey, a 7-year-old boy, was brought in a critical condition with chronic kidney disease. He was suffering from the kidney disease for several years and had a very poor growth. His height was only 95cms and his weight was 13 kgs. He was critical and managed with peritoneal dialysis. Haemodialysis is more difficult in such a small child. His general condition improved over the next 4 weeks with regular CAPD. The mother was very keen to

donate her kidney. She was found fit as a donor. A team of pediatric anaesthetist and intensivist were linked to the regular kidney transplantation team headed by Dr. Rajan Ravichandran.

The kidney transplantation was successfully carried out on 14th October 2010. Post operatively there were some anxious moments since the patient had to be kept on the ventilator almost for 48 hours. Fortunately the kidney picked up well and the child improved progressively. The CAPD dialysis catheter was removed 2 weeks after the transplantation. The child and mother both were discharged from the hospital in a healthy condition and it is now 2 months since the transplantation and the child is remarkably well.

The number of children transplant in less than 15kgs is very low all over the world especially in India. MIOT has successfully carried out this difficult procedure.