Waiting for a Pediatric Kidney Transplant

Step 2: Preparing for a Kidney Transplant

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We begin the process of finding a donor kidney once your child is approved for a kidney transplant. They may have the option of receiving a kidney from a living donor or wait for a deceased donor kidney on the national waitlist. We want to provide your child with a healthy, compatible kidney as quickly and safely as possible.

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Options for Kidney Transplant

Our experienced pediatric transplant team performs several types of kidney transplants -- including both deceased and living donor transplants. We are one of the few pediatric programs in the country to offer paired donor kidney exchange and incompatible-blood-type living donor transplants. These options create more opportunities for more children to receive a healthy kidney.

Deceased Donor Transplant

In a deceased donor transplant, the donor kidney comes from an adult or child who has passed away. To receive a kidney from a deceased donor, your child will be put on the United Network of Organ Sharing (UNOS) waiting list. Donated kidneys are matched to recipients based on blood type, common antigens (proteins), geography, and the recipient’s total waiting list time. Children under age 18 also receive priority for a kidney transplant.

Living Donor Transplant 

In a living donor transplant, the kidney comes from a living person. This can be a relative, a friend, or a stranger. Living donors must be 18 or older. They complete a medical and surgical evaluation to make sure they are in good health and can safely donate their kidney. People who receive kidneys from living donors may have fewer complications than those who receive kidneys from deceased donors and spend less time waiting for a donor organ.

Our Locations

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.

Paired Donor Kidney Exchange

If a relative or friend wants to donate a kidney to your child but has an incompatible blood type or unacceptable HLA antigens that the recipient makes antibodies against, we can arrange a kidney exchange with another donor-recipient pair. If your child is compatible with a donor from another pair, and vice versa, we can "swap" kidneys so that both recipients receive the kidney that is the best match for them. 

ABO Incompatible Kidney Transplant

If your child’s blood contains antibodies to a potential living donor's blood type, transplant is still possible. We are the only pediatric program in the region to offer ABO incompatible kidney transplants, which include treatments to lower antibody levels in the blood and reduce the risk of antibodies rejecting the donor kidney.

Is Your Child Ready for an Evaluation?

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.

The UNOS Waiting List

If your child is approved for a kidney transplant, they will be placed on the UNOS waitlist, even if a living donor transplant is planned. Your child can either be listed as active or inactive.

  • Active: Your child can receive an organ offer at any time. 
  • Inactive: Your child is not receiving offers but will maintain their place on the waitlist. They may be listed as inactive because they are waiting for a living donor to be approved or surgery to be scheduled, because they have an active infection, or for other reasons.

Time on the Waitlist

Time spent on the UNOS waitlist is different for every child. It is based on many factors including age, blood type, length of time on dialysis, sensitization (having antibodies that attack certain donor tissues), and others. While they are waiting, they will have monthly bloodwork and meetings with their doctors to help them stay as healthy as possible. Our pediatric transplant team is available 24 hours a day to respond to donor offers. 

Step 3: Surgery

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 08/10/2023 by