Pediatric Kidney Transplant

When your child is suffering with end stage renal failure, a pediatric kidney transplant is often the only treatment that can improve the length and quality of your child’s life.

When kidney transplant is an option for your child, your child’s care team at Rush will focus on your child’s physical, emotional and developmental needs.

Remarkable Care for Kids

  • Advanced techniques: Pediatric specialists in the kidney transplant program at Rush are highly experienced in the most advanced transplant techniques and procedures for children.
  • Experience with complex cases: The pediatric kidney transplant team is highly experienced in handling the most complex cases.
  • A transplant team that is always ready: Rush has been actively involved in local and national organ-sharing programs for nearly 30 years. The pediatric transplant team at Rush is available 24 hours a day to respond to offers of organs for your child.
  • Support for the whole child: Child life specialists at Rush University Children’s Hospital help children cope with their health challenges, while also helping them have positive experiences in the hospital.

Pediatric kidney transplant: things you should know

  • Child’s age and size: To ensure the safest and most effective transplant, children should be at least 18 months old and/or 22 pounds.
  • Kidney condition: If children have large, cystic kidneys, the transplant surgeon may need to remove one or both kidneys prior to receiving the new kidney.
  • Timing: The progression of renal failure is unpredictable, which makes it important to find a suitable kidney donor sooner rather than later.

Is your child a good candidate for pediatric kidney transplant?

To determine if your child is a good candidate for a kidney transplant, your child will need to undergo a thorough evaluation, which includes the following:

  • A complete physical exam
  • Blood tests
  • Chest X-ray
  • Echocardiogram

After the evaluation, you and your child will meet with your child’s care team to discuss the next steps.

Kidney donors

Your child’s new kidney will come from a kidney donor, which can include one of the following:

  • Living donor: From a healthy family member, friend or acquaintance
  • Deceased donor: From a registered organ donor who has recently passed away

Live donor transplants

People have two kidneys, but they can live with just one. This makes it possible for family members and friends to donate a kidney to your child. Typically, your child will be able to receive a kidney from an adult.

For your child: benefits of live donor transplants

  • There is a greater chance of long-term success with living donors.
  • Kidneys from living donors usually begin working immediately.
  • Your child will likely feel dramatically better shortly after the transplant.

For live kidney donors: information about donating a kidney

Specialists at Rush are highly experienced laparoscopic surgery for live kidney donors.

  • During this surgery, your surgeon makes small incisions in your abdomen.
  • The surgeon then inserts the necessary instruments, including a camera and laparoscopic instruments.
  • Your surgeon will then separate the kidney and remove it through a small opening.

Laparoscopic donor nephrectomy (kidney removal) offers the following benefits:

  • Lower risk of infection
  • Decreased pain and discomfort
  • Faster recovery
  • Shorter hospital stay

Pediatric kidney transplant surgery

During the surgical procedure, your child’s transplant surgeon will implant a healthy kidney from a donor. Here are some important things to know about your child’s transplant surgery:

Before surgery

  • Your child will be under general anesthesia and unconscious during the surgery.
  • Your child will need a temporary bladder catheter to measure urine output.
  • Your child may also have a central venous catheter (usually placed in the neck) to allow the care team to draw blood and give your child intravenous (IV) medications before, during and after the surgery.

During surgery

  • Your child’s surgeon will make a 5- to 10-centimeter incision on your child’s abdominal near the groin to implant the new kidney.
  • Your child’s surgeon will then connect the artery and vein of the new kidney to the artery and vein going to your child’s leg (just above the groin). This allows blood to flow through your child’s new, healthy donor kidney.
  • Your child’s surgeon will also connect the ureter from the new kidney to your child’s bladder. This allows urine from the new kidney to pass into your bladder.
  • Your child’s surgeon will usually not remove your child’s kidneys during the surgery, unless your child has cystic kidneys (which the surgeon will remove prior to the transplant).
  • During the surgery, your child’s transplant team will give your child anti-rejection medication (immunosuppressant drugs) to prevent the immune system from attacking the new kidney.
  • Throughout the transplant, your child’s transplant team will pay close attention to your child’s fluid management and blood pressure.
  • Pediatric kidney transplant surgery takes two to four hours.

Immediately after surgery

  • After your child’s surgery, your child will be in the pediatric intensive care unit (PICU) for close monitoring.
  • If your child does not have any complications, your care team will transfer your child to the general pediatric floor one to two days after surgery.

What to expect after the transplant

After the transplant, your child will need some time to recover. However, you will likely notice that your child will begin to have more energy soon after surgery. Here are other important things to know about life after transplant:

  • Your child will need to take a number of medications to prevent organ rejection for the rest of his or her life.
  • These medications can lower your child’s ability to fight off infections, so it is very important to teach your child how to prevent infections (e.g., handwashing, dental hygiene).
  • Your child will need regular follow up with a pediatric nephrologist to monitor and manage kidney function and medications, as well as other health conditions.