Kidney Transplant

If your child has advanced kidney disease, kidney transplant may be the best option.

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Kidney transplant allows children to return to a nearly normal life: attending school, playing sports and engaging with the world.

Kidney transplantation increases children’s life span and improve growth and development. After transplant, children develop healthier bones and brains, and experience reduced psychological stress when compared to dialysis.

A kidney transplant generally improves a child’s energy, sleep, and learning. After transplant, your child will be able to return to a more typical schedule including interacting with family and friends. Although medication to prevent rejection will be needed for life, children are free from the burden of dialysis sessions and chronic illness.

One of the nation's best pediatric transplant centers

The kidney transplant program at University of Iowa Stead Family Children’s Hospital is the only pediatric kidney transplant program in Iowa. Our comprehensive care is coordinated by pediatric specialists dedicated to transplantation and committed to treating each child and family as we would our own. We are approved by the United Network for Organ Sharing (UNOS) to care for children of all ages and have a long track record of outstanding outcomes.

Our team-based care is delivered in a child-friendly environment and a patient- and family-centered approach. Pediatric transplant surgeons, nephrologists, anesthesiologists, and urologists work together before and after transplant to ensure patients receive their transplant with the best plan at the right time.

Our transplant surgeons and nephrologists take the time to explain your child’s path to transplant, develop strategies to address any unique issues facing your child, and are here to support your family through this journey.

More than 185 children have received kidney transplants at UI Stead Family Children’s Hospital since 2010.

Read more kidney transplant statistics and outcomes data

Pediatric Transplant Centers

We also have world renowned expertise in pediatric rare renal diseases such as the complement diseases, atypical hemolytic uremic syndrome (HUS) and complement 3 glomerulopathy (C3G). The Rare Renal Disorders Clinic and the Molecular Otorhinolaryngology and Renal Laboratory provide comprehensive clinical, functional and genetic screening services for related disorders. These facilitate a tailored approach to each child.

These experts ensure that patients transplanted with these conditions at UI Stead Family Children’s Hospital can access state-of-the-art treatments, including novel therapies as part of clinical trials. For many children, this offers hope their best chance for long term kidney function after transplant.

Pediatric Kidney Transplant Outcomes

	All Donors	Living Donors	Deceased Donors
Transplants evaluated over a 2.5 year period	19	9	10
Estimated percentage alive with a functioning transplant at 1 year	100%	100%	100%

Source: Scientific Registry of Transplant Recipients between 01/01/2021 and 06/30/2023.

	UI Health Care	National
1 year post-transplant graft (organ) survival	100%	97.42%
1 year post-transplant patient survival	100%	99.46%

A team of experts dedicated to pediatric kidney transplant

Your child’s kidney transplant care is provided by a multidisciplinary team. That means the team is composed of specialists from different medical fields and other health care experts who all work together to create the best plan for your child’s individual needs. The team includes:

Pediatric transplant surgeon
Pediatric transplant nephrologist
Pediatric urologist
Pediatric nurse practitioner
Clinical transplant psychologist
Pediatric transplant nurse coordinator
Pediatric dietician
Pediatric social worker
Financial counselor

The Pediatric Kidney Transplant Process

Learn more about each step in the journey of kidney transplantation. From pre-evaluation to transitioning into adulthood post recovery.

Jump To:

Pre-transplant evaluation
Medical tests
Approval for transplant
Transplant surgery
Post-surgery hospital stay
Post-transplant care
Transition to adulthood

Pre-transplant evaluation

Kidney transplant evaluation involves a full day with our team. Our specially trained team works with your family to teach you about transplant.

During your child’s evaluation, we discuss all aspects of the transplant process, including the evaluation process, options, waiting period, surgery, recovery, and care following discharge. You will meet surgeons, physicians, social workers, dieticians, and your child's transplant nurse coordinator, a registered nurse who specializes in pediatric organ transplantation. The transplant nurse coordinator will assist your family through preparation, education, and listing.

Our goal is to provide a safe and timely path toward transplant for your child. Our transplant team will discuss the many options for transplant including living kidney donation, which is performed just down the hall in the adult hospital. For children with individuals who wish to donate but are not a match, the University of Iowa is an active participant in the National Kidney Registry exchange program. This allows kidneys to be exchanged within a national network of other hospitals so that each recipient can receive a living donor organ which is compatible. For patients who are waiting on the deceased donor list, the transplant center will review options to ensure that transplant is performed as quickly as possible.

Medical tests

During the evaluation visit, your child will complete blood tests, a chest X-ray, heart ultrasound (echocardiogram), and electrocardiogram (EKG or heart rhythm strip) in a child-friendly environment. These tests help our team develop a personalized care plan that will increase the likelihood of a successful transplant.

Our child life staff will be available to assist your child if any anxiety arises during medical testing.

Additional testing may be needed to make sure your child’s bladder and urinary tract are healthy for a transplant. The pediatric urology team is available to advise if additional testing is required.

Kidney transplant provider examining a patient

Approval for transplant

When the evaluation is completed, our multidisciplinary kidney transplant team gathers to review all relevant medical information to ensure your child is a good candidate for transplant. All members contribute to the discussion, and a decision is made about further testing, additional treatment, and when your child should be added to the waiting list.

If your child is approved for transplantation, he or she will be placed on the United Network for Organ Sharing (UNOS) deceased donor kidney waitlist. This is required even if there is an available living donor.

Kidney transplant providers discuss a patient

Transplant surgery

Patients awaiting a deceased donor organ may be called at any time. Kidney recipients are matched to possible donor organs according to blood type, tissue typing (cross match), and waiting time on the list based on national allocation rules.

At the time of transplant, patients are admitted to the pediatric nephrology floor in the UI Stead Family Children’s Hospital to prepare for surgery. Patients and families are given sufficient time to allow travel from across the Midwest.

The surgery can take about two to four hours depending on your child’s underlying medical conditions and any other additional surgical procedures required at the time of transplant.

Post-surgery hospital stay

After surgery your child will be admitted to the Pediatric Intensive Care Unit (PICU). You may visit as soon as your child is settled in, which typically is within one hour of return to the PICU.

Your child will be cared for by the PICU staff, which includes specialized pediatric nurses and the pediatric transplant team, as well as the transplant surgeon and nephrologist.

When medically ready, your child will move to the pediatric nephrology floor where we will work to develop life habits that will give your child the best opportunity to live a long time with their new kidney. We will adjust your child's medications based on lab results and make sure drinking and eating starts getting back to normal. Patients and families receive personalized and comprehensive education throughout their stay at UI Stead Family Children’s Hospital.

Post-transplant care

The transplant team is here to help pediatric patients and families transition into life after kidney transplant.

For the first two months your child will have more frequent laboratory tests that can be completed close to home and office visits in the Pediatric Specialty Clinic. During clinic visits we evaluate your child, talk about labs, and make sure you feel comfortable with your child’s care and medications.

After the first two months, we slowly decrease the frequency of lab checks and clinic visits as the risk of rejection of the organ goes diminishes, but never goes away.

All kidney transplant patients take antirejection medications for life. They need to be closely monitored by pediatric kidney transplant specialists until they are transferred to an adult kidney specialist, usually around the time they turn 21 or later if there are special developmental needs.

Kidney transplant providers discussing post care

Transition to adulthood

The University of Iowa Organ Transplant Center has developed a unique, integrated program to gradually transition late adolescent patients to adult care. Transition of care between pediatric and adult providers can be a period of high risk because this is when patients assume responsibility for their own medical care.

Our focused Transition of Care Program provides young adult patients and families with the tools to manage their transplant and ensure long-term function.

We work with adolescents as they mature into adulthood by providing high quality, developmentally appropriate health care services in the post-transplant setting. This process is gradual as we assist parents in challenging their children to do age-appropriate tasks.

We also incorporate the use of technology like MyChart and telehealth visits when your child is at college to minimize the need to leave campus to return for transplant visits. Eventually, patients transition to adult care in a seamless transition that builds on the skills developed over time.