New lease of life for a 2 years old post Kidney transplant

Background

Parents of a 6-month-old boy, brought him to the emergency department, where he was conservatively treated. The child was later diagnosed with a genetic disorder HLA 1 Beta 2 mutation with autism resulting in an end stage renal disease. At this neonatal age, transplant was the only modality of treatment option available for him.

Treatment

Over a period of 2 years, he was optimised in various multidisciplinary issues to prepare him for the Renal Transplant. After 2 years of intensive preoperative management, the patient underwent a renal transplant with his mother as the living donor. The procedure, led by Dr. Pradip Chakrabarti, Senior Consultant Transplant Surgeon, presented significant challenges due to the size mismatch between the adult donor kidney and the child’s smaller abdominal cavity space. Vascular connection required meticulous suturing to connect the donor's renal artery and vein to the patient's iliac vessels, ensuring adequate perfusion while preventing vascular tension. Prolonged general anaesthesia essential to keep the patient stable throughout the process was also a cause of concern. Despite the inherent complexities, the transplant was successfully completed, representing a critical milestone in the patient’s clinical course.

Post operative care and Recovery

Handling a child with special needs is challenging & more so specially when the mother has also undergone surgical intervention herself. Apart from our surgeons, our junior doctors, nursing team and caregivers ensured that they deliver the responsibilities not only with precision but with a sensitive parental touch.

The patient remained on prolonged mechanical ventilation, further complicating his care. The other challenges were to maintain his stability, manage his electrolyte levels and ensuring proper medication administration.

 The liaison among the various multidisciplinary departments was a key factor behind the success of the surgery as well as smooth recovery. By the twelfth day, he began walking and on the twentieth day, the child left the hospital healthy and smiling. His story is a testament of resilience, meticulous care, and immense love of family.