Eight-year-old girl with rare genetic condition gets kidney transplant

Eight-year-old girl with rare genetic condition gets kidney transplant

A UK-first treatment for an eight-year-old child has prevented her from taking life-long drugs to stop her body from rejecting her kidney transplant.

The immune system of Aditi Shankar was programmed after a stem cell transplant and as a result her body accepted a donor kidney as its own, clinicians have told the news agency.

The bone marrow transplant and kidney came from the same donor - Aditi's mother - and the new kidney is working without the need for drugs that stop the body from rejecting a donated organ.

Immunsuppressants, which serve a crucial function after transplant surgery, exacerbate the body's immune system, causing any person taking them to be at greater risk of an infection.

They usually need to be taken for life, but Aditi stopped taking the drugs a month after her surgery thanks to the pioneering work of doctors at Great Ormond Street Hospital in London.

Her mother, Divya, said she was 'happy and proud' to donate both bone marrow and one of her kidneys to her daughter.

She was spending a significant portion of her time in and out of hospital just last year, which is a procedure that removes waste products and excess fluid from the blood when the kidneys have stopped working properly.

Aditi was first referred to Gosh by doctors when she was just five, and doctors discovered she had a rare genetic condition called Schimke's immuno-osseous dysplasia, which affects the immune system and kidneys.

For every three million children in the UK, doctors are likely to find only one case.

The first treatment offered for Aditi was dialysis, and her family home in Greenford, north west London, had to travel from her family home in Greenford, north west London, to central London for treatment at least three times a week.

She lost her kidney function in March 2021, but a kidney transplant was not possible because her immune system was so weak.

Gosh's renal, immunology and stem cell transplant teams worked with international colleagues to come up with a treatment plan.

For four weeks, Aditi was in the intensive care unit, where she had her bone marrow transplant while dialysis for 24 hours a day.

In March 2023, Aditi was well enough to receive a kidney transplant.

Aditi's favourite class in school is science, and she has a deep interest in biology after learning so much about the human body during her time in hospital.

Professor Stephen Marks, children's kidney specialist at Gosh, said: I lead the kidney transplantation programme at Great Ormond Street Hospital and have worked here for over 25 years and she is the first patient in the United Kingdom who has had a kidney transplant to not require immunosuppressive medication after the surgery.

In addition, Aditi was able to accept her mum's bone marrow, which then meant her body could then see her mother's kidney as part of her.

It's exciting for Aditi to be the first patient in the United Kingdom, the first patient under the National Health Service, to have a kidney transplant for this condition and to be off immunosuppression within a month.

Asked about the potential use of the double procedure among other patients, he said: 'Everything in life, especially in medicine, is about the risks-and-benefit ratio.

If we have to balance each individual case, we have to go through this double transplant with a bone marrow transplant, then followed by a kidney transplant six months later, which is a significantly higher risk of causing injury to the patient and also death, so we always have to balance each individual case.

Dr Marks will present details of the case at the European Society for Paediatric Nephrology conference next week. The editorial details the findings are also due to be published in the journal Paediatric Transplantation.