Kidney Transplant: Pre-Transplant Evaluation

Pre-Kidney Transplant Evaluation

Before getting a kidney transplant, the Pediatric Kidney Transplant team at Cincinnati Children’s will evaluate your child. This evaluation gives the team information about your child’s overall health so they can better prepare for the kidney transplant.

The first step in your child’s transplant evaluation is tissue typing. Your child and any potential living donors need to have this blood test done. This test tells us if anyone is a good match for your child.

Tissue typing from your child and any potential living donor gives us information about their:

  • ABO type (blood type)
  • HLA type (antigen matching)
  • Crossmatch (whether there are antibodies that would increase the risk of rejection)

ABO Typing

ABO typing provides us with your child’s and the donor’s red blood cell type (AB, A, B or O). The red blood cell type must be compatible for a kidney transplant. The chart below shows suitable matches. 

For Blood
Type
Can Receive a Kidney
From This Blood Type
Can Donate a Kidney
to This Blood Type
O O O, A, B, AB
A A, O A, AB 
B B, O B, AB 
AB O, A, B, AB AB 

HLA Typing

HLA, or “human leukocyte antigen,” typing is used to help find the best donor match for your child. Specific transplant antigens are found on white blood cells and other cells in the body. Like your blood type, you inherit these antigens from your parents and they remain the same throughout your lifetime.

HLA typing is done to make sure the donated kidney is as compatible as possible. The more antigens that match, the better the chance the body will accept the kidney. This is true for both living donor and deceased donor transplants.

Crossmatch

A crossmatch tests your child’s blood with the blood cells of the donor.

If there are antibodies in your child that react against antigens in the donor, this is called a positive crossmatch. With a positive crossmatch, there is a higher chance the body would reject the donor kidney. Typically the transplant would not be performed.

A negative crossmatch, which is when there is no reaction between you and the donor’s blood cells, is typically needed for the transplant to occur.

Other Evaluations

After tissue typing is completed, the transplant coordinator meets with you and your family to discuss all aspects of transplantation. They will give you written material about the pre- and post-transplant process, medicines, possible complications and follow-up care.

Your child may also have the following:

Testing

  • Blood tests: These are done to find out your child’s antibody status to viruses such as HIV, hepatitis, chicken pox and others that could cause problems once your child takes immunosuppressant medicines after transplant.
  • ECHO / EKG: This test evaluates your child’s heart health prior to transplant.
  • Radiology imaging tests: These tests provide the surgical team information about vascular access and the condition of the kidney that needs replacing.
  • Voiding cystourethrogram (bladder X-ray study): This test is done only if there is a question about whether your child’s bladder function is normal.

Evaluations

  • Surgical: The transplant surgeon meets with you and your child to discuss the surgery, its risks and benefits and post-transplant recovery.
  • Anesthesia: A member of the anesthesia team meets with you and your child to discuss anesthesia for surgery.
  • Psychosocial: A social worker or psychologist meets with you and your child to look at psychosocial barriers to transplant and identify any support services you might need prior to transplant.
  • Dietary: A registered dietitian meets with you and your child to evaluate their overall nutritional status. They may offer nutrition suggestions that will promote healing and recovery following transplant surgery.
  • Infectious disease: An infectious disease specialist meets with you and your child to review prior infections and inform the transplant team how to protect your child before and after kidney transplant.

Transplant Finance

You and your child will meet with someone from the transplant finance office to:

  • Review your current insurance benefits
  • Discuss the potential financial impact to you, both before and after transplant
  • Explore the potential for additional health coverage, if needed

Last Updated 06/2018