When her nine-year-old granddaughter Asmi was diagnosed with chronic kidney disease, 69-year-old Vimal Arde did not hesitate and stepped forward offering to donate her own kidney. While Asmi’s parents willingly offered their kidney, it was the grandmother who firmly insisted that this was her gift.
“My daughter-in-law Reshma has three children and the youngest is just one-and-a-half years old. How will she manage the children after donating her kidney,” the 69-year-old said. In a selfless act of love, Vimal Arde refused to let her son Kishore and daughter-in-law Reshma face the crisis alone and donated her kidney.
While the living donor kidney transplant was performed this September at Manipal Hospital, Kharadi a follow-up of the donor and the patient showed that both were recovering well. Asmi who stays with her parents in Chinchwad said they celebrated her birthday on October 16 and makes it a point to follow the doctor’s instructions which includes eating home-cooked food and staying well hydrated among others.
Asmi’s mother Reshma recalled that the diagnosis came as a huge shock to the family. “Asmi is my eldest daughter and just a week before the diagnosis she was participating in school’s sports activities. So, it was a huge shock when medical tests after a brief spell of fever and weakness showed 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,” Reshma said.
For the family, coming to terms with the need for a kidney transplant was emotionally overwhelming. During this challenging time, the 69-year-old grandmother Vimal who stays in Satara took charge and firmly stood by her son and daughter-in-law and donated her kidney.
The doctors admit that this was a rare case that showed age and familial relations can be considered when performing paediatric transplants.
Dr Manishkumar Mali, Consultant–Nephrology and Kidney Transplant, Manipal Hospital Kharadi, told The Indian Express that the considerable age gap between the donor and the recipient made the situation challenging.
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“The patient 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.
Patient’s 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,” Dr Mali said.
What also worked in the grandmother’s favour was that she did not have any medical condition like diabetes or hypertension. Vimal said that exposure to farm life with healthy food eating habits like jowar bhakri and vegetables grown at the farm has contributed to her good health. “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,” Vimal said.
On the surgical complexity in this case, Dr Anand Dharaskar, Consultant – Urology, Manipal Hospital Kharadi, said that kidney transplantation in children is always complex, particularly when the recipient is a nine-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 team work,” he said.
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