If your child has end-stage renal disease (when kidney damage is severe and the kidneys are failing) our caring, highly skilled, and experienced Solid Organ Transplant team can offer the hope of a kidney transplant. With more than two decades of experience and numerous successful transplants our team oversees one of the largest pediatric transplant programs in the country.
The kidneys act as the body’s filtering system. They help control water levels and eliminate wastes through urine, as well as regulate blood pressure, red blood cell production, and the levels of calcium and minerals. Kidney failure (also called “renal failure”) is when the kidneys slow down or stop filtering blood effectively, causing waste products and toxic substances to build up in the blood.
Kidney failure can be:
- acute (which means sudden and sometimes temporary): may be due to bacterial infection, injury, shock, heart failure, or
- chronic (occurring over time and usually long-lasting or permanent): In kids and teens, it can result from acute kidney failure that fails to improve, birth defects, chronic kidney diseases, or chronic severe high blood pressure. If diagnosed early, chronic kidney failure can be treated. But the child will usually require a kidney transplant at some point in the future.
Kidney Diseases Leading to Dialysis and Transplantation
A large ongoing study called the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) is designed to monitor long-term trends in the development of kidney disease and changes in the management of patients with end-stage kidney disease. According to the most recent statistics from this large database, the majority of children end up in renal failure and in need of a kidney transplant from the following causes:
- Underdevelopment of the kidneys (renal dysplasia and hypoplasia): when (for unknown reasons) a baby is born with less kidney tissue or the existing kidney tissue doesn’t function normally
- Glomerulonephritis (an inflammatory process within the kidneys): which affects the glomeruli (small structures in the kidneys that supply blood flow to the filtering part of the kidneys)
- Focal segmental glomerulosclerosis: when scar tissue forms in the glomeruli and protein leaks into the urine; some cases don’t improve with medication and require transplantation
- Obstruction (blockage) of the urinary collecting system: when the blockage of the urine flow damages the kidneys and can occur while the fetus is still in the mother’s womb
Types of Kidney Donors
Your child may be able to get a donated kidney in one of two ways,
- living donor: either a relative (this is called a “living related donor”) or another unrelated person who the care team determines is a
- deceased (or cadaver) donor: the most common way, donated by a healthy adult or child who became critically ill and died of an illness (after the person or his or her guardians agreed to donate the organs in the event of a sudden death).
Our kidney transplant team performs living-related donor procedures whenever possible. Of course, not every child can get a living donor, but this technique does make it possible for more children to receive a kidney transplant as soon as possible and increases their chances of long-term survival after the transplant. If there’s no willing and compatible living donor your child will be waiting until a kidney becomes available from the local and national organ donor waiting lists.
How a Kidney Transplant Works
Once your child gets the team’s OK after all of the required tests and consultations (see Solid Organ Transplant for more information) and a deceased or living donor match is found, your child is ready for the transplant surgery. Your child will only need one donor kidney, which can take over the function of both failing kidneys.
For the transplant, your child’s original kidneys are usually left in place, except in rare cases where they’re removed because they’re too large from disease or they’re wasting protein.
The transplanted kidney may either start to work immediately or it may take a few days to get up to speed.
Patients who’ve had kidney transplants will need to be admitted directly to our Pediatric Intensive Care Unit from the operating room. Here, they’ll be monitored carefully during the first few days after surgery. Children can usually eat again in a few days and begin to resume some normal activity soon after.