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Kidney Transplants in Children

A large number of children lose the function of their kidneys every year. Many of these are because of various medical conditions which have no effective treatment. Many children are born with structurally normal kidneys but unfortunately lose their function because of diseases which lead to severe kidney damage if not diagnosed and treated on time. The load of preventable kidney failure seems to be higher in our country than in developed countries. Lack of awareness and misconceptions among the public along with lack of quality healthcare centres which are dedicated to understanding and treating kidney diseases in children contributes to this scenario to a large extent.

Children with kidney failure require long term treatment in order to lead a healthy life. Treatment is most commonly in the form of dialysis. Dialysis or Renal Replacement Therapy in children is frequently carried out via tubes implanted into the abdomen or into major blood vessels connected to the heart. With improving technology and modern treatment methods, the outlook for these children is good, but the quality of life enjoyed by these children is far from ideal. The best form of Renal Replacement Therapy in children is a Kidney Transplantation which can provide a near normal quality of life and cut down the need for frequent hospital visits that other forms of dialysis requires.

Kidney Transplantation in children has evolved over the last few decades and can be offered to even very small children, unlike in adults, the results of kidney transplant in children are still evolving. The results in older children are comparable to or even better than in adults in some situations. Managing extremely low weight recipients of a kidney transplant is a much bigger challenge. Newborn infants were considered unfit for kidney transplant but more and more pediatric centres are developing the expertise in providing care for these children.

A multidisciplinary centre with experience in catering to kidney diseases specific to children is important in achieving optimal results in pediatric renal transplant. Teamwork by a large number of specialists with expertise in Pediatric Nephrology, Pediatric ICU care and Pediatric Transplant Surgery are important to providing ideal care to these sick children. Important support and inputs from Pediatric Radiology, Dietetics, and other supportive departments are essential to deliver the best results possible.

Increasing community awareness, patient education, preventive care and timely referrals are important components of care in this group of patients which is often overlooked. If these wider measures are employed more effectively, we can together reduce the load of kidney failure in the country, leading to fewer children with preventable conditions requiring kidney transplants and improving the outcomes of those children who eventually require renal transplants.

Dr Mainak Deb

Consultant Pediatric surgeon, Pediatric Urologist and Pediatric Renal Transplant Surgeon

Bannerghatta Road, Bengaluru, Bannerghatta, Banjara Hills