No abstract

Background: Solid organ transplants (SOT) being the ideal replacement therapy for end organ failures, aim was to identify trends in pediatric transplants across India, its growth from 2013-2019, effect of COVID-19 pandemic, compare with global and WHO SEARO region. Methods: 2013-2020 yearly data of transplant centers, donation and transplantation submitted by identified WHO focal points in member states to GODT was collected, analyzed for pediatric patients. Results: In India 1,522 pediatric transplants (324 DDOT & 1,198 LDOT) were conducted from 2013 to 2020, majority being kidney and liver. Renal transplants exhibited seesaw graph until 2019 when a surge was witnessed followed by a drop in 2020 due to COVID-19 (Fig 1). Contrarily, liver transplants increased till 2020, COVID-19 having negligible effect. Pediatric cardiac transplants were performed in 2013, the first country in the SEARO region (11 countries). Pancreatic transplant started in 2016 and lung in 2017. Living donor transplants were more common due to limited number of pediatric DDs with resultant shortage. There were 324 DD pediatric transplants in 8 years, organs sourced from 174 DDs. India has the maximum number of kidney (560), liver (186), heart (151) and lung (78) transplant centers in the world. Only India performs all the above pediatric SOTs in SEARO, while Thailand does renal and liver transplants. India jumped from 10th to 5th place globally in the total number of pediatric transplants. Conclusions: India exhibits a rising trend in the number of pediatric renal and liver transplants. Efforts are required to increase DDs. Despite being LMIC adequately trained professionals make India the third largest transplanting country and fifth in pediatric transplants. Uniform distribution of transplant facilities is needed. Demand supply gap depicted by data can be bridged by training and dedicated transplant departments as per NOTP guidelines.