Pediatric Kidney Transplant Program

Our Living Donation Program empowers individuals to give the gift of life through kidney or liver donation, offering comprehensive support and expert care to both donors and recipients, ensuring a smooth and rewarding donation process.

The EqKT Program is dedicated to addressing disparities in kidney transplantation by improving access to life-saving transplants for underserved populations, ensuring every patient has a fair chance at receiving the care they need.

The Legoretta Center for Clinical Transplant Tolerance focuses on innovative research and therapies aimed at achieving immune tolerance in transplant recipients, reducing or eliminating the need for lifelong immunosuppressive drugs while improving long-term transplant outcomes.

The GOAT Program is dedicated to supporting adult transplant recipients as they navigate life post-transplant, offering life skills training, health monitoring, and community support to help them thrive. Through tailored resources and ongoing guidance, the program ensures recipients continue to lead healthy, fulfilling lives after their transplant.

The PATH Transitions Program equips young kidney and liver transplant recipients with the education, coaching, and peer support needed to smoothly transition from pediatric to adult care. Tailored to meet the unique challenges of adolescence and young adulthood, the program ensures a seamless shift from Mass General for Children to adult transplant care at Mass General Transplant Center.

Kidney failure, or end-stage kidney disease (ESKD), typically happens for different reasons in children than adults. The most common causes for pediatric kidney failure are:

• Birth defects that may result in lack of healthy kidney formation and function, restricted blood flow, or chronic infection
• Genetic, or inherited, diseases such as polycystic kidney disease
• Kidney infections, which can sometimes produce an inflammatory response that causes damage to the kidneys 
• Systemic diseases, which affect other organs in the body
• Kidney trauma or injury that cause a sudden and severe decline in blood flow to the kidneys

The most common causes of pediatric kidney failure often depend on the child’s age:

• Birth to age four: kidney birth defects (congenital) and genetic diseases
• Age five to 14: genetic and systemic diseases
• Age 15-19: damage to the blood vessels in the kidney (glomeruli)

Diagnosis of pediatric kidney failure is challenging. If the cause is hereditary or congenital, chronic kidney disease may be caught while your baby is in utero. For children, chronic kidney disease often does not cause distinct symptoms. If symptoms are present, they may include:

• Flu-like symptoms, such as fatigue and fever
• Decline in school performance due to lack of concentration
• Swelling of the hands, feet, or area around the eyes
• Change in frequency or color of urination
• Loss of appetite
• Headaches due to high blood pressure
• Stunted growth

The Mass General for Children Nephrology Program has a network of locations throughout New England with opportunity for virtual appointments when appropriate. This kidney doctor will care for your child before, throughout, and following their transplant journey until they transition into adulthood.

The evaluation process includes medical, surgical, and psychosocial assessments, as well as lab and imaging tests. The pace of this evaluation is set by you, the parent. We work closely with families to ensure the child is ready for the transplant both emotionally and physically. Our team is always accessible and tailors care to each child's unique needs. The same doctor will care for your child before, during, and after the transplant, ensuring consistent and personalized care throughout the entire process.

Download the roadmap (PDF)

The Mass General for Children Pediatric Kidney Transplant Program at Mass General Transplant Center performs kidney transplants on children of any age, as long as they meet the minimum size requirement. Our team evaluates each child individually, considering factors such as their size, weight, overall health, and medical condition(s) to determine if they are suitable candidates for transplantation.

Potential donors undergo a multi-phase evaluation including health screening, consultations with a living donor advocate, and final review to ensure their safety.

Yes, our Living Donor Program guides potential kidney donors through a thorough evaluation process. Living donation provides a quicker path to kidney transplantation with better outcomes.

The size of the kidney is one of many factors considered, and parents often successfully donate kidneys to their children. The size compatibility of kidney is one of many factors determined during the donor evaluation.

Wait times vary based on factors like blood type, how well the donor kidney matches your child, and whether your child has antibodies that might react to the new kidney. To get started, your child needs an evaluation with the multidisciplinary transplant team, which is scheduled within two weeks of receiving the referral or appointment request. Thereafter, we work at a pace that feels comfortable for your family. Contact us for more information at mghkidneykids@mgb.org or 617-724-1218.

Dialysis is a therapy for patients with end-stage kidney disease and can keep them alive while they are waiting for kidney transplantation, but not all children require dialysis before getting a kidney transplant. Whether or not a child needs to start dialysis prior to transplant surgery depends on their condition—the length of time they spend on dialysis depends on their age and when a kidney becomes available.

Your child’s doctor will determine if dialysis is needed or if your child can progress to transplant right away before ever needing dialysis, which is known as a pre-emptive transplant.

HLAs are proteins found on the surface of cells that serve as markers for the immune system to recognize the body’s own cells versus foreign substances. These markers pay an important role in the immune system’s ability to respond to potential threats, such as viral or bacterial infections.

Immunosuppressants, or antirejection medications, are drugs that weaken the body’s ability to attack a transplanted organ. This defense system is known as the immune system.

Children who undergo kidney transplantation often feel an improvement soon after surgery. As Mass General Transplant Center (or Mass General for Children) kidney transplant recipients stay in the hospital on average three to five days after surgery, depending on their individual case.

Before going home, your Mass General for Children transplant team will create an individualized care plan, prescribing your child medications to help manage their pain, avoid infection, and prevent kidney rejection. Immunosuppressants – medication to prevent organ rejection – is needed every day, and parents will work closely with our team to help their child manage this important part of their post-transplant care.

Children and their families get additional support through GOAT and PATH support programs.

Kidney transplant is the recommended and best treatment for children with end-stage kidney disease. At Mass General for Children, you and your child have access to the latest surgical techniques and a highly specialized, multidisciplinary team—this means that your child has an excellent chance for a much-improved quality of life and long-term survival following transplant surgery versus.

Most insurance plans cover the majority of transplant-related costs for the recipient. Our team helps families understand coverage details during the multidisciplinary evaluation with their dedicated care team.

The Pediatric to Adult Transplant Health (PATH) ensures a seamless experience as children who received an organ transplant transition to adult transplant care, minimizing disruptions during this high-risk period.