First Pediatric Deceased Donor Kidney Transplant in Chhattisgarh

Dear Editor,

In India, pediatric kidney transplant (KT) was started in the 1990s.¹ In the United States, approximately 800 pediatric KTs are performed annually. No national registry tracks the number of pediatric transplants performed or on the waiting list in India.² There are a few pediatric transplant facilities in the public sector. We share our experience with the first pediatric deceased donor kidney transplant (DDKT) in Chhattisgarh.

A nine-year-old male was diagnosed with end-stage kidney disease in November 2022. His family was counseled about preemptive KT; however, no suitable donor could be identified. He required emergency hemodialysis owing to fluid overload followed by the initiation of continuous ambulatory peritoneal dialysis. Later, he was registered for the DDKT program, and after being waitlisted for nine months, he was offered a kidney from a 15-year-old child who was declared brain-dead after a traumatic brain injury.³ He was discharged with a nadir creatinine of 0.21 mg/dL on postoperative day ten. At two months of follow-up, the child is doing well with creatinine 0.42mg/dL.

State Organ and Tissue Transplant Organisation (SOTTO) was formed in Chhattisgarh in 2022,⁴ which paved the path for deceased organ donation. The organ allocation policy of SOTTO gives priority to pediatric patients if the deceased donor is a child.

Pediatric kidney transplantation rates in developing countries are reported to be as low as < 4 pmcp (per million child population).⁵ Finding a suitable living donor is a critical limitation. Children should not be left out in deceased donor registrations. Since November 2022, 14 DDKT have been done in Chhattisgarh, highlighting the role of public sector hospitals in kidney transplantation and making it accessible to children.