With more than two decades of experience and hundreds of successful transplants helping children like yours, our Nemours Solid Organ Transplant team at Nemours/Alfred I. duPont Hospital for Children (AIDHC) oversees one of the largest pediatric liver and kidney transplant programs in the country.
If your child has end-stage kidney or end-stage liver disease (when damage is severe and the liver or kidneys are failing) our caring, highly skilled, and experienced Nemours Solid Organ Transplant team can offer the hope of a transplant, as well as comprehensive evaluation, treatment, and ongoing care.
Our coordinated team of Nemours health care providers, with multiple areas of expertise, are energized by the quality of health care we’re delivering to these children – and the bright prospects that our transplant recipients have for full and healthy lives.
Whichever kind of transplant your child is going to have at Nemours we know that the transplant process can be difficult and stressful. Finding the right match and waiting for a donor organ can be emotionally exhausting for both you and your child. No matter how long your child’s journey through transplantation may be, know that our commitment to providing guidance, support, and care starts the minute you come to us for your child’s transplant – and continues long after you’re able to take your child home after the surgery.
The Transplant Evaluation
To make sure that a transplant is the best treatment option and to see if your child is a good candidate for a transplant, we’ll start the transplant evaluation (or “work up”) process, which will involve:
- a meeting with members of your Nemours transplant team, which includes a surgeon, social worker, transplant coordinator, and a specialist (such as a hepatologist for children with liver disease or a nephrologist for children with kidney disease)
- a comprehensive physical examination
- a medical history (including making sure all routine immunizations are up to date and that your child has been taking all medications and following the recommended diet)
- consultations (meetings with specialists in areas like the kidneys, liver, heart, infectious diseases, hearing, and psychology)
- some tests (such as blood work, a chest X-ray, abdominal ultrasound, hearing test, heart tests like an electrocardiogram/EKG, and an electroencephalogram/EEG to detect brain abnormalities)
The transplant evaluation can be done in steps, either in a Nemours clinic or in the hospital depending on how sick your child is at the time of evaluation. We do these tests and consultations so that we can evaluate your child as a whole and make sure that any problems are addressed pre-transplant. Once all studies are done a member of the transplant team will call you to set up another meeting.
Types of Transplant Donors
Your child may be able to get a donated liver or kidney in one of two ways, either from a:
- living donor – a relative (this is called a “living related donor”) or another unrelated adult
- deceased (or cadaver) donor – the most common way, donated by a healthy adult or child who became critically ill and died of this illness (after the person or his or her guardians agreed to donate the organs in the event of a sudden death)
As soon as the transplant team decides that a transplant is the right option, your child will be placed on local and national organ waiting lists (which have the names of all of the people who need kidneys, livers, or other organ donations). A group called the United Network for Organ Sharing (UNOS) oversees this list and assigns organs based on how sick a person is, how quickly the patient needs a new organ, and which person is the best match for the organ donated.
Every year thousands of people are placed on the organ transplant waiting list – and some have to wait months, even years. For every person transplanted, two more are placed on the list. But living donation allows patients to be transplanted, with healthy organs, in a timely fashion, with very good long-term results.
At Nemours, we were early adopters of living-related donor procedures, which allow a living relative to donate a segment of the liver or one of their kidneys for transplantation. This technique makes it possible for more children to receive a transplant as soon as possible – and increases their chances of long-term survival after the transplant.
Of course, although a living donor is the best, fastest way to get a kidney or liver transplant, not every child can get a living donor, even if relatives or family friends are interested. Potential donors have to be screened to make sure they’d be a good match (for example, to make sure they have the same blood type – and other markers – as the child and that the organ to be donated is healthy). The screening process also includes tests (like blood work and an electrocardiogram, or EKG) that make sure the donor doesn’t have any conditions or infections that would put his or her own health – or the child’s – at risk. If all the studies indicate that the donor is a good fit to donate the organ, then we can schedule the day for surgery.
If no living donor is available, our Nemours team members (especially the transplant coordinators, child life specialists, social workers, psychologists, psychiatrists, and clergy) will be there for you every step of the way as you wait for an organ – offering the emotional support and resources you and your child need to cope. (Learn about all of the caring, highly skilled members of your child’s transplant team.)