Background: ABO blood type incompatibility between a donor and recipient is generally considered a contraindication to kidney transplantation.
Case characteristics: A 12-year-old boy presented with end stage renal disease (blood group B), with the only healthy available donor being mother (blood group AB). The child received renal transplant with mother as the donor, with a designed desensitization and immunosuppressive protocol.
Observation: At 6 months, child is doing well, with stable graft function.
Message: ABO-incompatible kidney transplantation is a valid alternative for children with end stage renal disease. This is the first report from India of a Pediatric ABO incompatible renal transplant.