Pre-Kidney Transplant Evaluation
Before undergoing a kidney transplant, the Pediatric Kidney Transplant Program team at Cincinnati Children's Hospital Medical Center will conduct a pre-transplant evaluation.
The purpose of the pre-transplant evaluation is to give the transplant team a thorough picture of your child's overall health status so that they can do everything possible to ensure a successful transplant outcome.
The first step in your child's transplant evaluation is Tissue Typing. This is a blood test done on the recipient and any potential living donors. The tissue typing determines several things:
ABO Typing
This determines the recipient's and donor's red blood cell type (AB, A, B, or O). The ABO type must be compatible in kidney transplantation. The following chart identifies suitable matches:
| Blood Type | Can Receive From Type | Can Donate to Type |
| O | O | O, A, B, AB |
| A | A, O | A, AB |
| B | B, O | B, AB |
| AB | O, A, B, AB | AB |
If a potential donor's kidney does not match the recipient's blood type, donation/transplantation may still be possible, for example, through a paired donation program. Cincinnati Children's Hospital Medical Center participates in such a program, The North American Paired Donation Network.
HLA Typing
The letters HLA stand for "Human Leukocyte Antigen" and refer to the identification of specific transplant antigens (genetic markers) on the recipient's and donor's white blood cells.
These antigens are inherited from your parents and remain unchanged throughout your lifetime. This typing is performed to ensure that the donated kidney is as compatible as possible with the recipient.
The more antigens match, the better the chance that your body will accept the kidney and that the transplant will have a successful outcome. This is true for both living donor and deceased donor transplants.
Crossmatch
In this test, your child's blood cells are tested against the blood cells of the donor. If there are antibodies in the recipient that react against antigens in the donor, this is called a positive crossmatch.
A positive crossmatch would indicate that the chance for rejection of the donor kidney is high and the transplant would usually not be performed.
A negative crossmatch, or no reaction between the recipient's and donor's cells, is therefore typically necessary for the transplant to occur.
After tissue typing has been completed, several other tests and evaluations are scheduled. These include:
- Education Session With The Transplant Coordinator:
The transplant coordinator will meet with you and your family to instruct you on all aspects of transplantation. You will be given written materials and have the opportunity to view videotapes on transplantation. These materials will cover both pre- and post-transplant information, medications, complications and follow-up care. - Blood Tests:
These are done to determine your child's antibody status to certain viruses such as HIV, hepatitis, chicken pox and other viruses that could potentially cause problems once your child is taking immunosuppressant mediations after transplant. - TB Skin Test
- Voiding Cystourethrogram (bladder X-ray study):
This test is done only if there is a question as to whether your child's bladder function is normal. - Surgical Evaluation:
Your child will be scheduled to meet with the transplant surgeon to discuss the transplant surgery, its risks and benefits, and post-transplant recovery. - Anesthesia Evaluation
- Psychosocial Evaluation:
You and your child will meet with the social worker or psychologist to assess any psychosocial barriers to transplant and identify any necessary support services that need to be arranged before transplant.
Rev. 1/07
