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Becoming a candidate and preparation

Pediatric kidney transplant patient criteria

The UF Health pediatric kidney transplant team assists children who are currently experiencing, or at risk of experiencing, kidney failure and desire kidney transplantation from either deceased or living donor. There are a number of conditions that can lead to kidney disease, dialysis, and transplantation. Some of the most common conditions that lead to pediatric kidney transplant include:

  • Posterior ureteral valves
  • Obstructive uropathy
  • Polycystic kidney disease
  • Focal segmental glomerulosclerosis
  • Hemolytic uremic syndrome

Patients with pediatric kidney disease may also have bladder dysfunction. The pediatric urology team at UF Health works closely with our pediatric nephrologist and kidney transplant team to develop treatment plans that support successful organ transplant.

Candidates for kidney transplant

Medical providers can refer patients at 17 years old and younger to our program. The following criteria is considered by the multi-disciplinary committee to proceed with transplant evaluation:

  • Can safely undergo a major surgical procedure
  • High probability of returning to a near normal life following transplant
  • Ability to attend all clinic appointments
  • Ability to comply with all medical recommendations
  • Advanced kidney disease

Conditions that can delay or prevent transplant

  • Active infection
  • Cancer within the last 12 months
  • Severe, uncorrectable cardiovascular and/or peripheral vascular disease
  • Body mass index greater than 40
  • Use of drugs and/or alcohol
  • Lack of reliable transportation
  • A combination of medical issues that will likely preclude long-term graft function and/or survival

Pre-transplant evaluation

Referral process

  • Pediatric Kidney Transplant External Intake Form PS147992. Your hospital or primary care doctor should complete this form to prepare for bringing you to UF Health.
  • Patients referred for transplant may or may not be on dialysis at the time of referral. Pediatric patients who are not yet on dialysis may have the option of preemptive kidney transplantation due to irreversible kidney damage and declining kidney function.

Evaluation process

  • Referral received and reviewed by transplant team
  • Financial authorization from patient’s insurance carrier is obtained by UF Health financial advisor
  • Transplant team will call candidate’s family to schedule evaluation
  • Evaluation includes – diagnostic testing and appointments with transplant nephrology, transplant surgery, transplant education with transplant coordinator, transplant social work, and financial counselor

Transplant evaluation review

  • After the evaluation is complete, a multi-disciplinary committee will meet to review all diagnostic tests to determine if the patient is a candidate for kidney transplant. The committee will discuss any medical issues that may need to be addressed prior to transplant listing or could be a contraindication for kidney transplant. Members of the committee will also discuss any barriers within the family that could hinder the success of kidney transplantation. Decisions to list a patient for kidney transplant are based on agreement of medical professionals. Each patient is evaluated on an individual basis to determine best treatment option for the patient.

Listing with the United Network of Organ Sharing (UNOS)

  • Status 1 (Active): Patient is listed with UNOS for deceased donor kidney transplant. The patient could receive a call for kidney transplant at any time.
  • Status 7 (In-Active): Patient is listed with UNOS, but will not receive any calls for deceased donor while listed in-active. Patient’s may be listed in-active for transplant for various reasons including but not limited to kidney function greater than 20%, currently resolving medical or family concerns, and to evaluate possible living donor candidates.
  • Defer: Patient is given at least 6 months to reconcile any medical or family concerns that would hinder a successful kidney transplant. The patient’s case will be reconsidered at 6 months or after medical and/or family concerns are resolved.
  • Deny: Committee decision is that kidney transplantation is not the best option for the patient at this time. The patient’s medical provider may send a new referral once circumstances for denial have been resolved.

Transplant success

UF Health pediatric kidney transplant program remains above the national average for 1-year patient and allograft survival. The Scientific Registry of Transplant Recipients is routinely updated with patient and graft survival rates of transplant centers across the country.

Life after transplant

Post-transplant appointments, diagnostic testing, and medication adherence is critical to maintaining the child’s new healthy kidney. Clinic appointments following transplant will initially be twice a week to closely monitor kidney function and medications. These appointments will become less frequent over time with the patient appointments occurring every three months at a minimum. Immunosuppression medications prescribed post-transplant will be required for the entirety of the child’s lifetime and must be taken at precise times each day. Your transplant coordinator will provide continuous transplant education.