PEDIATRIC KIDNEY CARE

Procedure

Pediatric Kidney Transplantation

Kidney transplants can transform the lives of children with end-stage kidney disease, freeing them from dialysis and enabling them to enjoy full, active lives. We have dedicated kidney transplantation programs for children and adolescents, featuring teams of experts offering comprehensive care. Thanks to the medical and surgical advances we’ve developed, our success rates for pediatric kidney transplant recipients exceed the national average.

What is a Pediatric Kidney Transplant?

What is a Pediatric Kidney Transplant?

Pediatric kidney (renal) transplant is a surgery in which a child with diseased or failed kidneys receives a healthy kidney donated by another person.

Common reasons for kidney failure in children are having a malformation at birth or a genetic condition that affects the urinary system. More specifically, these and other causes include:

  • Posterior urethral valves (extra flaps of tissue that grow over a boy’s urethra)
  • Anorectal abnormalities
  • Cloacal disorders
  • Neurogenic bladder (lack of bladder control due to a brain, spinal cord, or nerve condition)
  • Nephrotic syndrome (passing too much protein in the urine)
  • Systemic diseases such as lupus, hypertension, or diabetes

When you bring your child to NewYork-Presbyterian for kidney transplantation, you’ll benefit from a customized team of pediatric transplantation experts assembled to provide your child and family with exceptional care before, during, and after kidney transplant surgery.

How is a Pediatric Kidney Transplant Performed?

Procedure

After steps are taken to prepare for a child’s kidney transplant, and a matched kidney is available, surgery can take place. The procedure takes about four hours. Our transplant teams have extensive experience in techniques to ensure your child’s safety. Members of the transplant team will communicate with parents throughout the surgery.

  • The operation is done under general anesthesia, so the child can lie still and not feel pain.
  • Transplant surgeons make an incision (cut) in the lower abdomen.
  • Procedures to correct bladder abnormalities may be done before the transplant.
  • The new kidney is positioned and connected to the recipient’s blood vessels and bladder.
  • The nonfunctioning kidneys may be left in place or removed.
  • The recipient is given medicines that help prevent complications.
  • Surgeons close the incision.

Living Donor Kidney Program

Receiving a kidney from a living donor has many benefits, including better kidney survival rates, shorter waiting times, and immediate kidney function after surgery. For pediatric renal transplantation, the organ is frequently donated by a relative, but may also be from a friend or an altruistic donor. For many children, a parent is eligible to be a donor.

Our transplant teams also have found new ways of expanding the donor pool for living donor kidney transplant. For example, paired donor kidney exchanges anonymously match compatible donors with recipients when a suitable donor cannot be found among family members or friends.

With this technique, a donor who is not a match for their child donates to another individual, and their child receives a kidney from another matched donor, whose child receives a kidney from another donor, and so on. This approach has dramatically increased the number of kidneys available for pediatric transplantation.

Risks to Consider

Risks

Kidney transplant is the most common and successful of all transplant procedures in the United States. However, as with any surgery, there are risks and potential complications. Medications and frequent doctor visits are needed for the rest of a transplant recipient’s life. Before deciding on kidney transplant, ask the doctor about your child’s risk for:

  • Organ rejection
  • Infections
  • Hypertension (high blood pressure)
  • Side effects of medicines that suppress the immune system

NewYork-Presbyterian is at the forefront of using genetic methods to detect transplant rejection early and using anti-rejection approaches with fewer side effects. We are committed to improving outcomes for all.

Preparing Your Child for a Kidney Transplant

Preparing

When you bring your child to NewYork-Presbyterian for kidney transplantation, you’ll benefit from a customized team assembled to provide your child with exceptional care. Your child will undergo a series of tests to evaluate his or her health in preparation for the transplant process. The medical team will also let you know what you can do to help your child stay as healthy as possible before the transplant takes place.

If your child’s kidneys can no longer function properly, we use a dialysis technique to do the work of the kidneys, as a bridge to kidney transplant.

The two types of dialysis are:

  • Peritoneal dialysis. A catheter is placed into the child’s abdomen. This approach is often used in newborns and very young children since it can be done at home at night while the child and family sleep.
  • Hemodialysis. The bloodstream is accessed through a vein. It is reserved for older children and is given at the hospital or in a dialysis center.

Your First Visit

Your family’s first step in the journey toward kidney transplantation in children is a full evaluation by our transplant team. You will learn about:

  • The types of kidney transplants we perform and what the transplant process entails.
  • What you need to know if you are interested in donating a kidney to your child.
  • What you’ll need to do if your child is placed on the waiting list for a kidney from a deceased donor. You’ll need to be reachable 24/7 and able to bring your child to the hospital quickly if a donor kidney becomes available.
  • What your child’s life will be like after transplantation. Your child will need to take medications and receive lifelong medical follow-up care, including periodic clinic visits, to stay healthy.

What to Expect After Your Child’s Kidney Transplantation

After the Surgery

Most children go home from the hospital within a week of kidney transplant. Your doctors will prescribe medications for pain, and for preventing infection and rejection of the new kidney.

Our teams have extensive expertise in immunosuppressant therapies and other medicines patients need after transplantation. The team is generally able to avoid using steroids in children. Without steroids, patients recover quickly and avoid many serious long-term side effects, including growth delays.

In the first year after kidney transplant, a child needs frequent checkups and takes medication daily. Kidney transplant recipients also need long-term medical monitoring, and we continue to care for our pediatric patients throughout their lives. Your doctor can give you specific instructions for managing your child’s health care.

FAQs

FAQs

Yes, an adult can donate a kidney to a child. In general, children over the age of 2 are able to receive a kidney from an adult.

Kidney transplant is the frontline treatment for children with end-stage kidney disease, with a high percentage of recipients surviving the first year after the procedure.

The youngest age for kidney transplant is about 1 year old, but the procedure is done more often at age 2 and older.

Yes, parents can donate kidneys to their children, providing they meet the medical criteria for donation.

On average, a kidney transplant in a child lasts about 12-15 years.

Get Care

Choose NewYork-Presbyterian for Pediatric Kidney Transplant Surgery

At NewYork-Presbyterian, our transplant specialists understand how important this procedure may be for you and your child. Call today to schedule a consultation and see if a pediatric transplant here is the best choice for you and your family.