Pune: Doctors at Manipal Hospital, Kharadi, Pune have successfully performed a living donor kidney transplant on a 9-year-old girl suffering from end-stage kidney disease. The child received a kidney from her 69-year-old grandmother in this rare and successful case, demonstrating that age and familial relations can be considered when performing paediatric transplants.
The 9-year-old, an active and intelligent child, was admitted to the hospital with complaints of low-grade fever, generalized weakness, and cough. Further treatment and test by the paediatrician revealed a critically low haemoglobin level of just 3 g/dl. Further investigations confirmed severely impaired kidney function, and imaging showed that both kidneys were extremely small and shrunken, indicating chronic kidney disease that had gone unnoticed due to the absence of urinary symptoms.
The diagnosis came as a shock to the family, who found it difficult to accept that their young child was facing kidney failure. Coming to terms with the need for a kidney transplant was emotionally overwhelming. During this challenging time, the young girl displayed remarkable courage, while her 69-year-old grandmother showed even greater strength by deciding to donate her kidney — a true testament to the power of love and hope within a family.
Speaking about the case, Dr. Manishkumar Mali, Consultant – Nephrology and Kidney Transplant, Manipal Hospital Kharadi, said, “The considerable age gap between the donor and the recipient made the situation challenging. The girl had irreversible renal failure due to a chronic, undiagnosed condition, and the kidney transplant was the best treatment option to not only save her life but also ensure a good quality of life. Patients’ grandmother, who volunteered to be the donor, underwent compatibility testing as part of the pre-transplant assessment and preparation. She underwent comprehensive cardiac, renal, and general health tests and was determined to be medically fit despite her age. This was a rare and demanding case involving a nine-year-old girl weighing just 14 kg and hypertension. The transplant was performed under general anaesthesia after a comprehensive pre-anaesthetic evaluation. After surgery, close observation and post-transplant care were provided to both the donor and the recipient.”
Commenting on the surgical complexity, Dr. Anand Dharaskar, Consultant – Urology, Manipal Hospital Kharadi, said, “Kidney transplantation in children is always complex, particularly when the recipient is a 9-year-old with small veins and low body weight. Because an adult’s kidney is almost 11 cm in size, it is necessary to make modified incisions and use extremely precise vascular suturing to safely place it within a small abdominal cavity. In this instance, the process was meticulously planned and carried out seamlessly with dedicated and efficient teamwork. Laparoscopic kidney retrieval minimizes discomfort, minimizes surgical stress, and speeds up recovery. It has changed due to laparoscopic donor nephrectomy, which enables even elderly donors to walk early and quickly return to their regular activities.”
Sharing her experience as a donor, grandmother said, “I have lived my life, but my granddaughter is just starting hers. When she started falling sick again, struggling to breathe and becoming too weak to even walk, it was unbearable to see her in this situation. When the doctors finally told us that her kidneys had failed, there was no question in my mind—I wanted to donate my kidney to save her. She is only nine, but she faced every test and every challenge with courage far beyond her age. The support and confidence we received from Dr. Malì and the entire team kept us strong. Today, seeing her smile and recover feels like getting a new life myself. As a grandmother, giving her this second chance is the biggest blessing God could give me.“
Mr. Parameswar Das, Hospital Director, Manipal Hospital Kharadi, Pune Said, “After surgery, both the donor and the child were closely monitored with intensive post-transplant care, including infection control, immunosuppressive treatment and regular kidney functions. On the third day, the donor was released, while the child was discharged on day eight with improved kidney function. This case highlights every patient, regardless of age, will have the greatest possible outcomes at Manipal Hospitals because of our team’s dedication to provide cutting-edge transplant care. The team also ensured specialised psychological support for the child, who remained in isolation post-surgery without parental presence, to help her stay calm, emotionally secure and cooperative during recovery.”
The procedure was led by a multidisciplinary team Dr. Manishkumar Mali (Consultant – Nephrology), Dr. Anand Dharaskar (Consultant – Urology), Dr. Ankit Sharma (Consultant – Urology), and Dr. Sunil Borde (Consultant – Anaesthesiology) Manipal Hospital Kharadi. The expert team ensured that the intraoperative course remained stable and safe throughout. The teamwork and medical skills led to a successful surgery and speedy recovery for both the donor and recipient.
