Your child’s kidney transplant team will work closely with you and your child, especially in the first year after surgery when the risks of rejection and infection are the highest. You can help your child stay healthy by attending all follow-up appointments, monitoring their vital signs daily, and making sure they take their prescribed medications.
After transplantation, your child’s immune system will not recognize the new kidney and may try to attack or reject it. That’s why it is important to get a kidney that matches your child’s immune system as closely as possible. Your child will also take immunosuppressant medicine to help prevent rejection. We personalize their immunosuppression strategy based on their specific needs. Our goal is to keep the transplanted kidney working for a long time.
Signs of rejection can include fever, decreased urine output, and weight gain, but your child may not show any symptoms at all. They will undergo a kidney biopsy about six months after transplant as well as regular blood work to test for rejection. Rejection can be treated successfully if problems can be addressed promptly -- usually with steroids and an increased dose of immunosuppressants.
If you want to make an appointment for a pediatric kidney transplant evaluation for your child, please contact us. Our team can help with next steps.
We offer both calcineurin-free and steroid-free anti-rejection medications tailored to your child’s specific needs. These options eliminate the long-term side effects associated with steroid use and help the transplanted kidney function longer. Your child will take immunosuppressants for the rest of their life. Because their body and immune system can change over time, we will monitor your child closely and adjust the dosage and medication type as needed.
Your child will also take drugs to lower the risk of infections, prevent blood clots, control acid reflux, and more. Your transplant pharmacist, transplant coordinator, and others will help you and your child manage and follow their medication routine.
Kidney transplant surgery is performed at Duke Children's Hospital and Health Center. Pre- and post-transplant appointments take place at our kidney transplant clinic within Duke Children's.
Coming to Follow-Up Appointments
Your child will have frequent visits with the transplant team for the first four months after leaving the hospital. Your child’s transplant coordinator will help you with your appointment schedule and help you find lodging, if needed. At every follow-up visit, your child will undergo testing to see how well they’re healing, monitor any medication side effects, and look for signs of rejection. Over time, these visits will occur less often, but you will still need to return to Duke for regular appointments.
Duke Children's Hospital & Health Center is proud to be nationally ranked in nine pediatric specialties.
Monitoring Vital Signs
You will be asked to keep track of your child’s blood pressure, pulse, weight, temperature, fluid intake, and urine output daily. Please bring the recorded information to all follow-up appointments. Changes in vital signs may indicate a need for medical attention.
Immunosuppression medications help your child’s body accept their new kidney, but they also increase the risk for infections, such as a cold, the flu, or other viral or fungal illnesses. This risk is greatest in the first six months after transplant and when they are on high doses of medication -- for instance, when being treated for an episode of rejection. By consistently washing their hands, avoiding crowds and sick people, and getting vaccines as recommend, they can lower their risk for infection.
Making the Transition to Adult Care
Practicing self-care after transplant is challenging. As your child grows into an adult, we work closely with them on managing prescriptions, looking out for signs of rejection, where to go for routine blood work, and more, until they are ready to safely transition to adult care.