Enhancing Awareness and Advocacy for Paediatric Organ Donation: An Anaesthetist’s Perspective in Successful En Bloc Kidney Transplantation from a Paediatric Donor

The global shortage of transplantable organs continues to limit access to life-saving transplan-tation. Paediatric organ donation represents a valuable yet underutilised resource due to ethical concerns, technical challenges and limited public awareness. En bloc kidney transplantation from paediatric donors has emerged as a practical strategy to expand the donor pool while preserving vascular integrity and nephron mass. We report a successful en bloc renal transplantation from a 5-year-3-month-old donor weighing 14.5 kg into a 42-year-old adult recipient with end-stage kidney disease secondary to hypertensive nephrosclerosis. Anaesthetic management focused on maintaining haemodynamic stability, optimising graft perfusion and balancing fluid administration in a recipient with significant cardiovascular comorbidities. Continuous invasive haemodynamic monitoring and goal-directed fluid therapy were utilised throughout the procedure. Attention was paid to maintaining adequate mean arterial pressure during vascular anastomosis and reperfusion while avoiding fluid overload in the presence of diastolic dysfunction. Immediate urine output following reperfusion indicated early graft function. The postoperative course was uneventful, and the patient was transferred from the intensive care unit after two days. This case highlights the im-portant role of anaesthetists in perioperative transplant management and underscores the need for greater awareness and advocacy for paediatric organ donation.