Successful renal transplant in pediatric patients

The Calcutta Medical Research Institute (CMRI), one of the largest multi-specialty hospitals in Kolkata celebrates “Sharing is caring with the Young Champions”. These unsung champs who are now in the mainstream of life successfully underwent kidney transplant and got a second lease on life. The skilled team of physicians and surgeons, together with efficient nursing care along high-end medical infrastructure have given a new hope and life to numerous young patients. With gratitude and kindness, patients today spoke about their experiences at the interactive session.

The renal transplant team of CMRI comprising Dr. Pradip Chakraborty, HOD Renal Science Department & Dr. Rajib Sinha, Consultant, Paediatric Nephrologist shared their opinion regarding complex transplant procedure. The dais was shared with Dr. Prof. Jaydeep Ray, HOD Department of Paediatric Medicine, Institute of Child Health (ICH)&Dr. Arpita Roychowdhury, Director of Regional Organ & Tissue Transplant Organization (ROTTO)& Chief Nephrologist SSKM along withDr. Sushmita Banerjee, Paediatrician CMRI& President of WB Paediatric Associationalso expressed the importance of paediatric transplant.

The limited access to tertiary level healthcare and limited trained paediatric nephrologists, transplant physicians lack facilities for paediatric dialysis, lack of effective deceased donor program, non-affordability, and non-adherence to immune suppressant drugs possess a major challenge to paediatric transplant in India. However, the scenario is changing rapidly and we are overcoming the hurdles rapidly but there’s a long way to go.

Speaking on the occasion, Dr. Pradip Chakraborty, HOD Renal Science Department, Senior Consultant Transplant Surgeon, explains that “At CMRI, we are privileged to have a state-of-the-art renal transplant department and we are the only center in Eastern India to run the pediatric transplant program with a team of qualified and highly experienced medical specialists, and support staff, comprising pediatric nephrologist, cardiologist, intensivist and surgeons. We would like to take this opportunity to strengthen our collaboration with the Institute of Child Health (ICH) which specializes in paediatric care. We have been running pediatric transplant programs with absolute surgical acumen, adhering to strict international protocols which results in excellent clinical outcomes. It gives me great pleasure in assuring quality life to the little champions because children have the potential to bring incredible change to our nation but first we need to strengthen them and give them our care and attention. I also, take this opportunity to thank the donors, the parents of the children who have come forward and have given the best gift to their little one.”

Dr. Rajib Sinha, Consultant, Paediatric Nephrologist explains that the need of the hour is awareness of kidney transplant. “Children who are subjected to end-stage renal failure can benefit from the advanced pediatric transplant program at CMRI. A kidney transplant is the ideal choice of kidney replacement therapy in children. One should know, worldwide over 1300 paediatric kidney transplants are performed every year but unfortunately due to lack of awareness India lags behind especially in the eastern part. We are trying to move the needle through our paediatric transplant program. Several successful pediatric kidney transplants have been performed at CMRI to date and we are hoping to continue this in future with idea to bring the best to this part of the world.

The enriching session focussed on patients like:

Wahisa Khan, a 12-year-old child initially diagnosed as a chronic kidney failure patient came to CMRI with gross volume overload of respiratory distress and her initial evaluation of cardiac status showed a gross cardiac dysfunction to an extent where she was advised a cardiac transplant by a cardiac surgeon. Since a pediatric cardiac transplant wouldn’t be viable, doctors at CMRI started a vigorous dialysis program and in 3-6 months a significant improvement in her cardiac status was observed. In a year, she responded very well to dialysis and need not require any cardiac transplant. Later, she was evaluated as fit for a kidney transplant. But the challenge faced by the kidney transplant team to have good perfusion of a new kidney, the heart needs to be in a good state to pump the right amount of blood to the kidney. After several brainstorming sessions between top cardiologists and nephrologists the entire team took a gamble on transplanting the kidneys which turned out to be the best decision and the patient was discharged in a good shape with absolutely no post-operative hiccups.

Alia, a 10-year-old child, came with an alputs disease which was genetically present with a hearing disability, and was diagnosed with end-stage renal disease. A team of experts at CMRI went ahead with a pediatric kidney transplant her mother being the donor. The transplant was a success and today, Alia is back to leading her normal life with no post-operative glitches.

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