Kidney transplants-An option for those with chronic renal failure (1153)
Key points below
(An Option for Those with Chronic Renal Failure)
Why do I need to know about kidney transplants?
Your child is living with chronic renal failure. The first treatment often used is dialysis. Your child may have been treated with dialysis. If so, it may be time to make choices about further treatment. One option is a kidney transplant. This handout will give you information about kidney transplants. Be sure to discuss this information with the health care team.
What is a kidney transplant?
Surgery is done to put a new kidney into your child’s body. The new kidney is donated from another person. This new kidney will take over for your child’s failing kidneys. There are many benefits with a transplant such as:
- No need for dialysis.
- Less diet and fluid restrictions.
- Feeling healthier.
It is important to remember that a kidney transplant is one type of treatment for kidney failure. It is not a cure.
Who can have a kidney transplant?
There are very few problems that prevent a transplant. If there are no physical problems that would prevent a kidney transplant, your child with chronic renal failure could have the transplant. Before having a kidney transplant, your child will have a transplant evaluation. This evaluation help the health care team see if there are any problems. Blood tests are also needed to “match” or select a donated kidney that is best for your child’s body.
What blood tests need to be done?
Blood type. There are four basic blood types. Letters are used to describe blood types. They are Type A, Type B, Type AB or Type O. The donated kidney must come from a person with a blood type that is compatible with your child’s blood type. In some cases, an incompatible blood type can be used. This must be full evaluated by your child’s transplant team to decide if it is a safe option.
| If your child's blood type is: | Your child can get a kidney from (compatible blood types): |
|---|---|
| O | O |
| A | A, O |
| B | B, O |
| AB | AB, A, B, O |
HLA type. HLA stands for Human Leukocyte Antigens. This test tells about your child’s genetic markers. It is sometimes called tissue typing. HLA is like a fingerprint. The closer the HLA fingerprints match, the better match there is between your child and the donated kidney. The health care team will work to find a donated kidney that matches your child’s HLA as closely as possible.
Antibodies. Our immune system makes antibodies. Antibodies fight a cell that is not from your own body. These are called foreign cells. When antibody levels are low, it is easier for your child’s body to accept a donated kidney.
What about my child’s general health?
The health care team will examine your child and ask questions. Many tests will be needed, including blood tests, x-rays and ultrasounds. This will help them know if your child is physically ready for a transplant.
Who is the health care team?
Many different people may be on the health care team depending on your child’s needs.
- Dietitian. A person specially trained in nutrition. The dietitian will teach your child about eating and drinking to stay healthy. The dietitian will also keep track of how well your child grows during treatment for chronic kidney failure.
- Nephrologist. A doctor who specializes in treating kidneys. This doctor will monitor how well your child’s kidneys are working.
- Psychologist. A person specially trained to see how well your child and family is coping with chronic illness.
- Renal/transplant nurse. A nurse who helps watch your child’s health before and after the transplant. This nurse will help plan for teaching done by the health care team.
- Transplant coordinator. A person who arranges for transplants. They will also help your child learn more about taking care of themselves before and after the transplant.
- Social worker. A person specially trained to offer physical and emotional support to your child and family. They can help with resources available for your child’s care. They also may work with insurance or government medical programs regarding health care.
- Surgeon. A doctor specially trained to do operations. This is the doctor who will put the donated kidney into your child’s body.
Where do donated kidneys come from? Kidneys for transplant come from two sources. No matter which one is used, your child’s transplant can be successful.
Where do donated kidneys come from?
Related living donor. A member of your family such as a father, mother, sister or brother.
Unrelated living donor. Someone you know who agrees to give your child a kidney, such as a friend.
A date for this type of transplant can be planned.
Deceased donor
The kidney comes from a person who has just died. The donor is carefully checked for health problems before the kidneys are removed for transplant.
Your child’s name will be put on a waiting list. The wait might be just a day or two, or it could take a year or more. There is no way to plan exact time or date when a kidney will be available. Because of this a member of the health care team must always know where you and your child can be reached.
More about the transplant waiting list
There are people all over the United States on the transplant waiting list. When a kidney from a deceased donor becomes available, the transplant list is checked. The list has all of the information needed to make the best match. There is no way to know how long your child will have to wait. Waiting for a kidney can be a hard thing to do. It may cause a lot of stress for you and your family.
What should my child do while waiting?
- Eat healthy foods. Your child should stay on the diet they are given by the health care team.
- Exercise. Your child can do as much exercise as they are safely able to do. Don’t overdo it!
- Use relaxation techniques. Your child can listen to music or imagine being in their favorite place. Deep breathing for a few minutes can help release tension.
- Stay involved with people and activities. Talking with your family and friends will help them understand your child’s feelings. It will also help your child and you feel more at ease with their kidney disease. Activities and hobbies help time pass more quickly and can help give your child a good feeling.
- Learn about kidney transplants. Ask the health care team for more information. They will be happy to help.
- Talk to others who have had a kidney transplant. Ask the health care team to put you in touch with someone the same age as your child who has had a transplant.
More about the transplant surgery
Before surgery
- For live donor transplants. Your child and the donor will come to the hospital a few days before surgery. They will have blood tests, a chest x-ray and a physical exam. Your child will be able to go home and come back to the hospital just a few hours before surgery.
- For deceased donor transplants: The transplant coordinator will call you when a kidney is available for your child. When you get this call, you and your child will need to come to the hospital as soon as you can. Be sure to drive safely. At the hospital, your child will have blood tests and a chest x-ray. One of the blood tests is called a final cross match. This means that your child’s blood is tested to make sure that the donor kidney is a good match. If it is not a good match, your child will not get this kidney. They will stay on the waiting list for another kidney.
Surgery. Most often the surgery takes 3 to 4 hours.
After surgery
There are two main problems (complications) that may happen after surgery:
- Infection. Caused by germs (bacteria), viruses or fungus. Your child will need to take special medicine to treat infection.
- Rejection. The cells in the body try to attack the cells of the kidney. This is because the cells in the body know that the cells of the donated kidney are foreign cells. If rejection is not treated, the new kidney will not be able to work.
Why does my child need medicine to prevent rejection surgery?
Special medicine called immunosuppressant or antirejection medicine is very important after transplant surgery. This medicine works to keep the cells in your child’s body from attacking the cells of the new kidney. This type of medicine may cause weight gain, swelling, growing more hair on your child’s face and body, and acne. Even though these things may happen, it is very important for your child to always take their medicine. Your child will need to take these medicines for life to keep the new kidney working well.
What happens after surgery?
- Activity. Your child will be in the hospital for about 7 days. Once at home, your child will need to restrict some of their activities for about one month.
- Follow-up care. Your child will need to be seen on a regular basis by the health care team. Blood tests, height, weight and blood pressure will be done. These things help the health care team know how well the new kidney is working. It is important for your child to come to every appointment so the health care team can help manage your child’s transplanted kidney.
Resources
- National Kidney Foundation (800) 622-9010
- United Network for Organ Sharing (888) 894-6361
For other health and wellness information, check out this resource: https://kidshealth.org/ChildrensWi/en/parents