[Skip to Content]

When Your Child Needs a Kidney Transplant

What Is a Kidney Transplant?

A kidney transplant is an operation where doctors put a donated kidney into the body of someone whose own kidneys don't work as they should. One healthy kidney can do the work of two failed kidneys.

Most kidney transplants are successful. People who have kidney transplants will take medicines for the rest of their lives to prevent the body from rejecting the kidney. Rejection is when the body's immune cells destroy the transplanted kidney because they sense that it's foreign.

But aside from that, many kids and teens who have kidney transplants go on to live normal, healthy lives after their surgery.

What Causes Kidney Failure?

In kids, kidney failure usually is due to:

  • Genetic diseases. Conditions that run in the family can harm the kidneys. One example is polycystic kidney disease, in which fluid-filled sacs replace normal kidney tissue.
  • Glomerular diseases. These conditions damage the tiny filtering units in the kidneys (called ).
  • Birth defects. Defects of the kidneys or urinary tract can prevent the kidneys from working normally.

Diabetes and high blood pressure are two top reasons for kidney transplants in adults. Both are becoming more common in kids and teens. It's unlikely that children with these conditions will need kidney transplants when they are young. But managing diabetes and high blood pressure now could help them avoid kidney disease when they become adults.

Treating the condition that's causing the kidney failure can sometimes help heal the kidneys. But this isn't possible if a person has lost more than 15% of his or her kidney function. When this happens, doctors recommend either:

  • a kidney transplant, which places a new (donor) kidney in the body
  • , a therapeutic process that does the work of the kidneys by artificially cleaning the blood

For children who are good candidates for it, transplant surgery can be the better option. Dialysis treatments are usually needed daily or many times a week. So they can interfere with a child's routine and make it hard to go to school or travel. Successful kidney transplants can make it easier for kids to live as they did before developing kidney failure.

What Are the Different Types of Kidney Transplants?

The two kinds of kidney transplants are:

  1. Living-donor transplants. This is when a person gets a kidney from someone who is still alive. Because people can survive with one kidney, a living person can give a healthy kidney to someone with kidney failure. A living donor is usually a relative or close friend of the person getting the kidney. In some cases, a kidney can come from a stranger.
  2. Non-living-donor transplants. This is when someone has died and his or her kidneys are donated for transplants. This requires children in need of a new kidney to have their name on a waiting list until a suitable donor is found. The wait for this kind of donated kidney often takes a year or more.

How Should We Prepare for a Kidney Transplant?

If your child's doctor recommends a kidney transplant, your first step is to visit a transplant hospital. A health care team there will make sure that your child is a good candidate for surgery. This may include blood tests, X-rays, and other tests, and can take a few weeks.

Then, a donor kidney can come:

  • from a close relative or friend with the same type blood and tissue and whose organs are similar in size to your child's
  • a non-living donor. Your child's name will be put on a waiting list.

If you're on the waiting list, you'll stay in close touch with your child's doctors and the rest of the health care team. Make sure they know how to reach you at all times. When a kidney is located, you'll need to move quickly. Keep a bag packed and be ready to go to the transplant hospital at a moment's notice.

While you wait, help your child stay as healthy as possible and ready for transplant surgery when the time comes. Make sure that your child:

  • eats healthy foods
  • gets regular exercise
  • takes all medicines as directed
  • goes to all medical appointments, especially if these include dialysis

Let the doctor and the transplant center know right away if there are any changes in your child's health.

What Happens During a Kidney Transplant?

When a suitable donor kidney is found, your child will go to the transplant hospital for the surgery. An antibody crossmatch test (a type of blood test) will confirm whether your child's immune system will accept the new kidney. In this test, your child's blood is mixed with the donor's blood to make sure they are fully compatible.

In the operating room, your child will get general anesthesia to sleep through the operation. The surgeon will make a small cut in the lower abdomen, above the hips. The new kidney will be placed, then the surgeon will attach its blood vessels to blood vessels in the lower body. The new kidney's (a tube that carries pee from the kidney to the bladder) will be connected to the bladder.

In most cases, failed kidneys stay in place. They're not removed unless they cause problems like high blood pressure or an infection.

Kidney transplant surgery usually takes about 3 to 4 hours. Often, the new kidney starts working right away, but sometimes this can take a few weeks.

What Happens After a Kidney Transplant?

After kidney transplant surgery, your child will spend a few days (or up to a week) in the hospital to recover. The health care team will watch your child closely to make sure there are no complications from the surgery, such as bleeding or infection.

Your child will learn how to take medicines — called — to keep the body from rejecting the new kidney. These are needed because the immune system sees a new kidney as a foreign object and will try to reject it. Immunosuppressants can make your child more likely to get infections, especially in the days right after surgery. So keep your child away from sick people and have everyone at home wash their hands well and often.

For the first few weeks after surgery, your child will see the doctor a lot to make sure the new kidney is working well. If your child gets a fever or is sore in the area of the transplant, tell a doctor right away. These could be signs that the body isn't taking to the new kidney. If the new kidney is rejected or fails, your child can go back on dialysis or perhaps have another transplant.

What Else Should I Know?

There's a good chance your child can do most of the things he or she enjoyed before. But it's important to ease back into activities and avoid rough contact sports like football, hockey, or wrestling. These could damage the new kidney. If you have questions about whether an activity or sport is OK, ask your doctor before you let your child do them.

Help your child eat well, exercise safely, and get enough rest to help keep the new kidney healthy.

The success rate of kidney transplants is very high. When the body accepts a transplanted kidney, it typically keeps working for 10 to 20 years. After that, a person will need another transplant or go on dialysis.

How Can I Help My Child?

Having a chronic condition can be hard for a child to deal with. Dialysis, surgery, and immunosuppressant therapy can add to the stress. Talk to your child about these changes and how you will work them into your routine. Make sure to find time to do fun things together with family and friends.

For teens, immunosuppressant therapy can be a challenge. These medicines can lead cause:

  • increased acne
  • weight gain
  • excess facial and body hair in women (called hirsutism)

These side effects are a major reason why teens are at risk for not taking their medicines after a transplant. This can be dangerous and even lead to rejection of the new kidney. So be sure to talk about the importance of taking all medicines as directed.

What else can you do?

  • Be there for your child to talk to.
  • If your child needs more support, make an appointment with a therapist or counselor.
  • Find a support group. They're a great way for kids and teens to relieve stress and connect with others who are going through similar challenges. Online resources include the National Kidney Center's Facebook page and Transplant Living.
  • Get support for yourself too. It can be a huge relief to talk about your feelings with other people who know what you're going through. Ask the transplant care team if they know of support groups for families.
Date reviewed: August 2018