NEW DELHI: A tiny life cut short. A giant gesture that will remain lifelong. When doctors at AIIMS in the city admitted a 16-month-old infant who had suffered a head injury after a fall, little did they perhaps know that the baby would lead them to perform a challenging organ transplant surgery involving child patients. The baby could not make it. His kidneys and liver, however, continue to breathe life — into two other kids.
The infant was admitted to AIIMS after he suffered the injury on Aug 17. He was declared brain dead on Aug 25. The family donated his kidneys and liver to two other children, while his heart valves and corneas have been preserved at the organ bank. His organs were transplanted the same day.The kidneys were given to a 5-year-old boy who was on dialysis after suffering from renal failure. According to doctors, he became the youngest patient in India to get en-bloc kidney transplantation, wherein two kidneys from the same paediatric donor, along with the blood vessels, are transplanted into a single recipient.
While this procedure is not rare in adults, it is uncommon in children due to complexities, according to Dr Manjunath Pol, who conducted the surgery.“In children, the blood vessels are thin and delicate. It requires precision to attach the whole renal set-up, including kidneys, to a child,” he said. “There was no room for even a minor error. The vessels were very small and there was a risk of blockages, which could lead to graft kidney failure.Also, the length of the donor’s ureter was small and the urinary bladder was underdeveloped. Any tension during the surgery would have led to ureter tear.”
The surgeons also faced difficulty in getting the right equipment.“Since the child was very young, we had to get small stents and three-way catheters used in setting up the kidneys,” Pol said. However, the biggest issue was minimising blood loss.“As the blood volume in children is minimal, the patient would not tolerate blood loss of over 20 per cent of their blood volume. We had to keep it at a minimum,” Pol said.
The recipient is on a road to recovery.“He is happy to go back to school and play,” Dr Sandeep Aggarwal, head, surgery unit at AIIMS, said.Talking about the deceased infant, Dr Deepak Gupta, professor of neurosurgery, said, “The child fought for eight days. He was born to donate.”