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  • Pediatric kidney transplantation

    Pediatric kidney transplantation is a surgical procedure that places a healthy kidney from a living or deceased donor into a child's lower abdomen. When harmful wastes build up in the body, treatment is essential to restore or replace the function of working kidneys. With end-stage kidney disease pediatric kidney transplantation is often a necessary, life-saving step that restores normal renal function and kidneys may come from a living donor or a deceased donor.

    Special care must be given to the emotional needs of children undergoing transplantation in addition to the medical requirements. Because most pediatric transplantation recipients are still growing and developing, it is vital to have a care team that is specially trained in pediatric medicine. Those typically involved in pediatric kidney transplantation in addition to physicians and nurses, include pediatric nephrologists, pediatric transplant surgeons, social workers, child psychiatrists, and dietitians.

    The procedure

    After general anesthesia is given, the transplanted kidney is placed in the pelvic area, usually on the lower right side. In very small children, the kidney is placed in the center of the abdomen. The surgery is performed by attaching the donor ureter to the bladder of the patient and attaching the arteries and veins already located in the patient’s pelvis to the new kidney. This allows normal urine and blood flow to be restored. The recipient’s kidneys are typically not removed.

    It normally takes between two and four hours to complete the surgery and the donor kidney should begin to function immediately. To be considered for a transplant, a child must be ages two through 18, weight at least 25 pounds, have irreversible end-stage kidney disease, current immunization status, and be following all recommended medical courses of treatment.

    Screening and qualification

    Thorough testing to qualify as a candidate is needed to decrease the risk of rejection of the transplanted kidney and increase the chance of survival for the child. The child must also undergo many tests to determine if transplantation is the best treatment option. During the initial visit, the child and family members will meet with a team of specialists to discuss the best treatment plan. A series of tests are required from the pediatric patient before transplantation. These tests can include:

    • Chest X-ray
    • Blood tests
    • Cardiac evaluation
    • Abdominal sonogram
    • Social work evaluation
    • Urology consultation
    • Dental and eye exam

    Benefits

    The benefits of pediatric kidney transplantation include an increased likelihood for a longer and more fulfilling life. Patients who have been on dialysis previous to the transplant report having more energy, fewer dietary restrictions and an increased chance of returning to normal activities such as school and work. Compared to those who remain on dialysis treatment, research shows that kidney transplant recipients live longer.

    Risks and complications

    All surgical procedures carry inherent risks. The potential risks and complications for pediatric kidney transplantation include the following:

    • Failure or rejection of the donor kidney. In these cases, a child would need to have another kidney transplant or be on dialysis while waiting for another kidney transplant.
    • Return of kidney disease after the transplant.
    • The possible side effects of anti-rejection medications and the long-term cost. Since pediatric kidney transplantation recipients will be lifetime takers of these medications, this is important knowledge to consider before undergoing the procedure.



Page last updated: 7/2/2013 11:36:43 AM