New Jersey Pediatric Kidney Transplant
Board-Certified Pediatric Transplant Surgeons Perform Lifesaving Operations
Board-Certified Pediatric Transplant Surgeons Perform Lifesaving Operations
A kidney transplant is often a necessity and the most effective treatment for children with end-stage chronic kidney disease, also called renal failure. Every year, about 1 in 65,000 American children experiences kidney failure, which can negatively impact their growth, bone strength, and nerves, in addition to their self-esteem, behavior, and ability to concentrate. A kidney transplant is the best treatment option for children who have end-stage kidney failure and a much better alternative than dialysis, which is both time-consuming and disruptive to a child’s social life and scholastic pursuits.
At RWJBarnabas Health, our pediatric nephrologists are highly knowledgeable and compassionate. They understand our young patients’ unique needs. We educate the family unit as a whole during what is a sensitive time. Our multidisciplinary team of pediatric nephrologists, social workers, and registered dietitians work together to achieve optimal results so kids can go on to enjoy healthy lives.
The Kidney Transplant division of RWJBarnabas Health is one of the most progressive centers for kidney transplant in the country, and the innovations developed for adults have been adapted for kidney transplants in children as well.
Who Is Involved in My Child’s Kidney Transplant Team?
Different healthcare professionals will be involved in meetings and tests in various stages of your child’s kidney transplant process. These may include the following medical personnel, among others:
- Urologist
- Pediatric Nephrologist
- Pediatric transplant surgeon
- Transplant nurse coordinator
- Transplant pharmacist
- Physiotherapist
- Occupational therapist
- Registered dietitian
- Licensed clinical social worker, psychologist, and/or neuropsychologist
- Child family life specialist
- Pediatric dentist
- Anesthesiologist
Why Does My Child Need a Kidney Transplant?
When the kidneys no longer function and waste cannot be removed from the blood, a child’s health will rapidly deteriorate as each organ system shuts down one by one. Dialysis treatment may have previously been an effective treatment to help do the work of two failing kidneys, but it is not a long-term solution. Once the kidneys both fail, a child will need a kidney transplant. Fortunately, only one kidney can adequately clean the blood and replace two kidneys and is an effective alternative to dialysis treatment.
Your child’s pediatric nephrologist will refer your child for a transplant evaluation to discuss the potential surgery, hospital stay, necessary post-operative medications, outpatient follow-up arrangements, and any other relevant matters associated with the transplant. Once your child is approved for a transplant, they will be placed on the United Network for Organ Sharing (UNOS) transplant list. They may either receive an organ donation from a live donor or a deceased donor.
If the donor is a “live donor,” meaning the kidney is transplanted from a living person, they must fulfill specific compatibility criteria with the intended recipient and they must “pass” a donor evaluation.
Live donor kidney transplants have a shorter wait time and are easier and more convenient to plan and schedule and typically have better long-term outcomes.
Kidneys from living donors tend to work longer and better, however, even a kidney from a deceased donor is a better option than having dialysis over an extended period of time.
Where Do Donor Kidneys Come From?
If a living donor cannot be found, your kidney donor can by anyone – child or adult – who has died from brain injury or disease, but their major organs can be salvaged for a short period of time with medications and machines so they can be removed and transplanted into another living person and continue to function as they did previously. The information regarding the deceased donor is kept confidential and private.
What Causes Pediatric Kidney Failure?
Most children who experience end-stage chronic kidney disease (kidney/renal failure) have genetic conditions, or birth defects that caused the kidneys to develop incorrectly in the womb. Some children may have developed kidney disease as a result of an infection, physical trauma, or a system condition such as lupus – although these reasons are much less common.
What to Expect During a Pediatric Kidney Transplant
Once your child is under general anesthesia to make them unconscious and unresponsive to pain, the kidney transplant may begin. The kidney transplant process is different depending on whether there is a live kidney donor or the kidney comes from a deceased donor.
The basic steps of a pediatric kidney transplant include:
- The pediatric transplant surgeon makes an incision on the child’s lower abdomen.
- The surgeon places the new kidney into the pelvic area of the child receiving the new kidney. The kidney is then connected to the relevant blood vessels and the bladder. The main connections include the renal artery and vein as well as the ureter, which is the tube that transports urine from the kidney to the bladder which is then expelled from the body. It is worth noting that the patient’s existing, nonfunctional kidneys are usually not removed during a transplant, and they do not affect the healthy donor kidney.
- During the transplant, your child may have other related conditions treated at the same time, such as related bladder or urologic conditions.
Recovery After a Kidney Transplant
Typically, a kidney transplant takes about 3 hours from start to finish until the child goes to the pediatric intensive care unit (PICU) for monitoring and recovery, followed by additional recovery in a regular hospital room for an additional 4 to 6 days.
For your child’s transplant to be successful, the most important work begins once they are home from the hospital. You will need regular follow-up appointments, particularly during the first year after your transplant.
In the first few weeks after the kidney transplant, your child may need blood tests every other day to check that their body is not rejecting the new organ and to determine whether they are taking the right amount of anti-rejection medicine.
Risks of Kidney Transplant for the Recipient
Both the recipient and the organ donor face significant risks undergoing kidney donation.
For the child who receives the kidney, there is the risk their body may try to reject the new organ. If this happens, you must contact their doctor immediately. These signs could indicate that the body is rejecting the kidney:
- Fast pulse
- Sudden swelling or weight gain
- Little urination
- Intense pain
- Fever
- Flu-like symptoms
There are also risks such as higher likelihood of infections and certain types of cancers because the child will need to take anti-rejection medication for as long as the donated kidney continues to work.
Your child will need to adapt to life with a new kidney by making important lifestyle changes. You and your family will need to do all you can to ensure they stay healthy so they can adjust to returning to school and learn how to manage their required medicines and stay active in their own healthcare.
Parents can help their children adjust to their new lifestyle and team up with a social worker who can guide families to health education programs for children. These programs, including summer camps for children and teens with transplants, can help them build social skills and learn how to live a healthy lifestyle.
Risks of Kidney Transplant for the Organ Donor
Kidney donation is major surgery, and there are risks associate for the donor, too.Although there are minimal long-term risks, there is a slightly increased risk that the donor might eventually develop kidney failure. This is even more true in middle-aged Black men, although the risk is still very small and translates to about less than 1 percent of future kidney failure.
Donors will go through intensive screening and a medical exam to determine whether they are compatible with the intended recipient to check for any potential health problems that may be made worse by donating one of their kidneys.
Will My Child’s Health Improve After a Kidney Transplant?
Generally speaking, yes. Most children have fewer dietary limitations. Their health and energy should improve, they will be able to travel again without being tethered to the dialysis clinic, and many will live longer than they otherwise would have if they had not had the surgery. However, not all donated kidneys last a lifetime, particularly in young transplant recipients. Most people who received kidney transplanted as children will need more than one kidney transplant in a lifetime.
Preparing Your Child for a Kidney Transplant
To discuss kidney transplant with a likely anxious child, you can sit them down and tell them what their incision will look like, tell them their pain will be manageable with medicine, and tell them doctors and nurses will be there for them to make them feel better. Remind them that the kidney transplant is to make them feel better than they feel now.
RWJBarnabas Health prepares children for kidney transplants by using age-appropriate materials to educate your child about their upcoming surgery and hospital stay, and gives them a chance to express their feelings in a safe, non-threatening environment. They will feel prepared, less anxious, and feel more in control. We encourage parents to express their feelings, too. Whether you are confused or overwhelmed or anything else – these feelings are all to be expected. If you have questions or concerns, our transplant team is here to help. Our Child Life specialists are also available to provide emotional and physical support to the child and family during their time in the hospital.
RWJBarnabas Health Pediatric Kidney Transplant Programs
New Brunswick, NJ
Livingston, NJ