The Chennai-based Kauvery Hospitals on May 10 announced that it has successfully performed a complicated renal transplantation on a 7-year-old underweight boy, born with an abnormality in the urinary passage.

Talking to reporters here, Hospital Chief Nehprologist Dr Balasubramaniyam said the boy, the boy was born with an abnormality in the urinary passage with a condition called vesicoureteral reflux, and was severely underweight for his age, as he weighed less than 15 kgs. Normally, the urine that was produced from the kidney should come down through the urinary bladder and it should go out. But in case of this patient, the bladder was abnormal and the urine, instead of coming forward was leaking backwards as well.

This predisposed the child to repeated urinary infections and he was prone to get into irreversible kidney failure over a period of time.
Dr Balasubramaniyam said “in 20 years of our experience we have done over 700 transplants.But we have never done a surgery like this. Apart from the risk of transplant on such a young kid, there are complications as three surgeries are performed on the same day''.

The option was to use one of the kidneys of his blood relatives. ''And in the boy’s case, we are glad that his father volunteered to donate. In any kidney transplant, the original kidneys are not removed unless in very rare circumstances where kidneys are the main reason for the infection or uncontrolled blood pressure'', he said. However, in this child, the kidneys were infected due to repeated urinary infection and thus they had to be removed.

The ideal situation was to remove the kidney, wait for the wounds to heal and then do a transplantation. However, if the kidneys were removed one month before the transplantation, the child has to undergo dialysis. ''In this case, we had to rectify the bladder first so the kidney can be implanted into the bladder'', he said. If this was not rectified, problems that happened to the old kidney could happen to the new kidney as well. After discussions with nephrologists and urologists, it was decided to avoid dialysis as it was difficult on a small child.

Hence, the boy underwent one kidney removal, a transplant and a bladder reconstruction, all in a day, Dr Balasubramaniyam said.
''It’s been more than one month since the surgery was done and the boy is fine with proper post-operative care and appropriate medication”, he added. Kauvery Hospitals Executive Director Dr Aravindan Selvaraj said “thanks to the efforts of Dr Balasubramaniyam and his team of experts, just in the last one year alone, we have done four complex renal transplants on children in the 7–12 age group.''

In the case of the boy, he could be among the smallest children in terms of body weight to have successfully undergone renal transplant. This has not just given the child a new lease of life, but has also created an awareness that children born with congenital abnormalities of the kidney and urinary bladder could get a successful transplant, Dr Aravindan said.