Pediatric kidney transplantation in Nepal

Area of Science:

• Nephrology
• Transplantation Surgery
• Pediatric Medicine

Background:

• Pediatric kidney transplantation is a critical treatment for end-stage renal disease in children.
• Emerging countries face unique challenges in providing advanced medical care, including transplantation.
• This report details the first pediatric kidney transplant program in Nepal.

Purpose of the Study:

• To describe the initial outcomes of pediatric kidney transplantation in Nepal.
• To assess the feasibility and success of living donor kidney transplants in young recipients.
• To establish a benchmark for pediatric transplantation in a resource-limited setting.

Main Methods:

• A retrospective review of pediatric kidney transplants performed at Tribhuvan University Teaching Hospital, Nepal.
• Inclusion criteria: recipients ≤17 years old, transplanted by September 2018.
• Data collected included demographics, renal function, rejection episodes, and complications.

Main Results:

• 517 living donor kidney transplants were performed, with 23 in pediatric recipients (≤17 years).
• One-year patient and graft survival rates were 100% and 89.2%, respectively.
• Acute rejection occurred in 13.3% of patients (2 cellular, 1 antibody-mediated).

Conclusions:

• Pediatric kidney transplantation is achievable and successful in Nepal.
• Children in developing nations deserve access to advanced medical interventions like kidney transplants.
• The program demonstrates positive outcomes, supporting the expansion of such services.