Pediatric Kidney Transplant Evaluation

Your child's doctor may refer you to the Pediatric Kidney Transplant Program at CHOP when it is suspected that your child might need a kidney transplant. Before your child is considered for a kidney transplant, we will perform a comprehensive transplant evaluation to determine if a transplant is your child’s best option.

The evaluation process is also an opportunity for you and your child to learn more about kidney transplantation and to meet the kidney transplant team.

What to expect

The pre-transplant evaluation, which is coordinated through the transplant office, is usually done on an outpatient basis over several days. You will be asked to sign a consent form to begin the process to show that you understand the purpose of the evaluation and what is involved.

You will meet with multiple team members, including a nephrologist, nurse practitioner, transplant nurse coordinator, transplant surgeon, anesthesiologist, dietitian, financial counselor, pharmacist, social worker, psychologist, and members of the infectious disease team.

Your child will have an echocardiogram (ultrasound that takes moving pictures of the heart and blood flow).

There may be other consults depending on your child’s diagnosis and clinical status. These may include pulmonary (lungs), cardiology (heart), neurology (brain) or urology (bladder).

Preparing for your child’s evaluation appointment

When you come to the hospital for your first appointment, be sure to bring:

• A list of any medications your child is currently taking.
• Any X-rays or other imaging studies (either copies or doctor’s reports).
• Your child’s medical records to date, including physicians’ phone numbers and past test results and vaccines received. Copies of these records should also be provided to CHOP before you arrive for your child’s appointment.

Your initial evaluation appointment will typically be on CHOP’s Philadelphia Campus. You can visit our directions page to get door-to-door directions from your area to the hospital.

Necessary blood tests

1. Blood Type: For an organ transplant to work, it is important that we find a donor who has a blood type that matches your child’s blood type. This is called ABO compatibility.
2. Human leukocyte antigen (HLA) testing: This is how we test for a “good match.” HLA is a group of proteins on cells that can trigger an immune response. There are three major human leukocyte antigens that we consider in matching for a kidney transplant.
3. Crossmatch: A crossmatch is a test that is done when there is a potential donor for a transplant recipient. The crossmatch looks at the HLA testing to determine how well the donor’s HLA matches the recipient’s HLA. The cross match makes sure there are no antibodies in the recipient that would potentially attack and damage a donor transplant.
4. Serology: This blood work looks to see if your child’s body has built up protection against certain infections such as CMV and EBV viruses. We also evaluate to make sure your child has received the age-appropriate and recommended vaccines.