Kidney Transplantation in Children and Adolescents

Chronic kidney failure can happen to children, just like it happens to adults of different ages. This disease gradually affects children’s health and eventually makes them undergo a kidney transplant or dialysis. Fortunately, in recent years, pediatric nephrology has developed a lot; therefore, kidney transplants in children have a higher success rate compared to kidney transplants in adults.

Today, pediatric kidney transplant is performed in Iran and many other countries around the world, so many children can now live a normal life without getting dialysis every day. In the following article, you will read the requirements, aftercare, and results of a kidney transplant in children and teens.

Reasons for Kidney Failure in Children

Kidney failure happens when the kidneys cannot filter blood as normal, and the toxins and waste products (like urea) remain in the body. The main causes of kidney failure include:

• Congenital kidney abnormalities and hereditary diseases, such as polycystic kidney disease (PKD), are the most common causes of kidney failure in children and adolescents. Fortunately, many of these problems can now be diagnosed during pregnancy via ultrasound scanning.
• In children over 12 years old, kidney inflammation (glomerulonephritis) can lead to kidney failure.
• Other diseases, such as vesicoureteral reflux, recurrent kidney infections, and kidney stones (renal calculi), can lead to kidney failure.
• Rare genetic and metabolic diseases, like cystinosis, can also cause kidney failure.

Signs of Kidney Failure in Children

When a kidney fails, it loses its ability to remove salts, excess water, and toxins from the body; therefore, the following signs emerge. If your child has a history of kidney problems, contact a doctor as soon as you notice the following symptoms in them.

• High blood pressure
• Nausea and vomiting
• General unwellness, medically known as malaise.
• Fatigue
• Chronic headaches
• Itchy skin
• Pain in the bones or changes in bone shape
• Decreased (Oliguria) or excessive (Polyuria) urination
• Swelling in the hands, feet, and face
• The child’s breath smells like urea

Requirements for Pediatric Kidney Transplant

For children, the doctors usually recommend a kidney transplant rather than other treatment methods. For several weeks to a few months before surgery, the doctor performs Continuous Ambulatory Peritoneal Dialysis (CAPD) to prepare the child’s body for transplantation. Peritoneal dialysis is much better than hemodialysis for children because it acts more like a normal kidney. In some cases, however, a kidney transplant is not necessary. For example, children who are born with one healthy kidney can live a normal life and do not need a transplant. In general, children must have the following conditions to be eligible for a kidney transplant:

• The kidney should reach the 5th stage of failure (the kidneys' function is reduced to less than 15%).
• The child’s clinical condition should be stable before surgery.
• All infections must be completely treated.
• The diet should be optimized so the body has the necessary nutrients.
• Blood pressure and cardiovascular problems should be fully controlled.
• The pelvic arteries and the urinary tracts should be tested to make sure they work normally.
• The child and their parents must be psychologically ready for the surgery and follow the post-op care carefully. 

Kidney Transplant in Children vs. Adults

Kidney transplants in children and adults are similar, but there are also some differences that cannot be ignored. The goal of a kidney transplant in adults is to increase their quality of life and lifespan. However, a kidney transplant can help children’s physical and cognitive development. Also, it allows them to eat normally and have normal lives at home and school. In other words, after a pediatric kidney transplant, children can focus on thriving rather than just surviving.

On the other hand, kidney transplantation in children is more difficult and delicate because, in most cases, a kidney from an adult donor is transplanted into a child’s body. Connecting the large blood vessels of the donor kidney to the child’s vessels is hard, so the surgeon must be very experienced, precise, and skillful.

Finally, adults must take immunosuppressive medications for life to prevent kidney rejection. For children, however, doctors prefer using stem cells to keep the kidney working for decades (and hopefully for life). The advantage of this method is that the medications won’t interfere with the child’s growth.

Age and Weight Limits for Pediatric Kidney Transplant

As mentioned earlier, the success rate of pediatric kidney transplant is even higher than in adults. But the children should be both physically and psychologically ready to undergo the operation; otherwise, the results won’t be satisfactory. In general, there is no age or weight limit for a kidney transplant in children. However, if the child’s weight is too low (for example, he/she weighs less than 10kg), the surgery is more complex because a large kidney must be connected to the child’s small arteries.

Pediatric Kidney Transplant Post-op Care

Pediatric kidney transplant post-op care is similar to that of adults. The most important point is to take medications as prescribed and on time. Here are 8 tips you should remember during the recovery period.

1. Since the risk of drug interactions is higher in children than in adults, children should only take medications with a doctor's approval.
2. The vaccination is different for children who undergo kidney transplant surgery; for example, live vaccines are prohibited for them because their immunosuppressant drugs can't fight them.
3. One of the side effects of immunosuppressive medications is hypertension, so the parents should check their child’s blood pressure regularly.
4. Children who undergo kidney transplant surgery have more dietary restrictions than other children. For instance, they cannot eat as much red meat, salt, or fast food as others.
5. The child should receive enough protein, iron, and minerals. These nutrients help them grow physically and cognitively.
6. The child’s height and weight should be monitored every six months, so if their growth slows or stops, the doctor can detect and resolve the issue in time.
7. Teenagers must avoid smoking and alcohol before and after the surgery.
8. Urinary tract infections and viral infections should be carefully monitored and managed.

Do Children Grow Normally after a Kidney Transplant?

Chronic kidney failure doesn’t allow the body to work and grow normally. Therefore, a successful kidney transplant, as well as the advanced techniques that reduce the need for immunosuppressive medications, helps children have a normal life. Moreover, this operation increases children’s life expectancy and quality of life. The nephrologists around the world hope that someday, children won’t need anti-rejection medications at all and can live a normal life, just like other kids.

Children’s Lifestyle Kidney Transplant

After a kidney transplant, most children will have an ordinary life. Of course, they will have some dietary and physical limitations and should be monitored constantly.

Diet and Activities

Children should avoid activities that put pressure on their kidneys and follow a healthy diet, filled with fiber and protein. They are allowed to play most sports after the surgery; however, it is better to avoid contact sports or weightlifting, as these activities may put excessive pressure on the abdominal area and damage the transplanted kidney.

Medications

Children and teenagers undergoing kidney transplant surgery cannot take risky medications without a doctor’s permission, especially when they are taking them for the first time. By risky medications, we mean certain antibiotics, NSAIDs (like mefenamic acid or ibuprofen), supplements, and herbal medications.

Checkups

Children should get regular checkups after kidney transplantation, so the doctors can detect early signs of kidney failure. Also, the patients should keep their weight within the normal range because being underweight and overweight can damage their kidneys.

A Quick Review

The procedure of a kidney transplant in children is similar to that in adults, although it generally requires greater surgical precision and specialized care. A successful transplant can improve a child’s quality of life, support normal growth, and reduce dependence on dialysis. Advances in pediatric transplantation and long-term follow-up have also improved outcomes in many countries. For families considering a kidney transplant in Iran, understanding the medical requirements, donor compatibility, surgical experience, and long-term follow-up is an important part of choosing the appropriate treatment pathway.

Get a free consultation, precise treatment planning, dedicated support, and a personalized medical travel roadmap. Contact the experts at Iran health agency today.

Contact Us

Contact us for a free initial consultation about Kidney Transplant

WhatsApp Telegram Facebook Email

FAQs

How is a kidney transplant in children with cystinosis done?

Cystinosis is an inherited metabolic disease that leads to kidney failure. Kidney transplant is an excellent treatment for these patients and has a high success rate.

Can a mother donate a kidney to her child?

Yes. Close relatives, like parents and siblings, can donate a kidney to a child. In fact, the kidneys from living donors have a higher success rate than those from deceased donors. In more advanced surgeries, stem cells may also be used during the kidney transplantation from mother to child.

Does a kidney transplant affect a child’s height?

Yes. Kidney failure prevents normal growth in children, so a successful kidney transplant can positively affect a child’s height.