Advantages of Kidney Transplant (KTR)

Renal Transplants in children :

Are done in Mumbai.

Gives new life to the child

Need to spread the awareness

Indications :

ESRD in children due to

CAKUT- Dysplastic kidneys, PU valves Reflux nephropathy

Acquired diseases- FSGS, MPGN, HUS

Hereditary problems- Alport, ARPKD

Operative differences in younger children :

Bigger incision to accommodate adult kidney

Intra peritoneal placement

Anastamosis with IVC and Aorta

Chances of hypotension on release of clamps

Immunosuppressive drugs :

Tacrolimus / CSA

MMF/ Azathioprine

Steroids

Induction +

 

Follow up:

Weight

Height

Blood pressure

General & systemic examination

CBC, S.Creat, SGPT, Urine Routine, Drug level

Cost :

Cost of the surgery: 5,00,000 Rs

Cost of immunosuppression: 1mg of Tacrolimus = 30Rs, 500mg of MMF = 40 Rs, So 1mg BD of Tac= 60 X 30 =1800Rs, 500mg BD of MMF = 80X 30= 2400 Rs, Azathioprine only 80 Rs for 10 tablets

How can we increase Kidney Transplant (KTR) in children :

Awareness – Kidney Transplant (KTR) done in children Cost affordable Results are good

Blood tests & follow up decrease over time

Immunosuppressive drug doses decrease over time so cost comes down

Recipient differences:

CMV status

Growth must occur post Kidney Transplant (KTR)

Expected Longevity much more than adults

Compliance must be assured by parents

Immunization must be complete

Assessment of bladder function