Pre-Kidney Transplant Evaluation

Before a kidney transplant, your child will have an evaluation by the Pediatric Kidney Transplant Program team at Cincinnati Children’s.

The evaluation will give team members 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. This is a blood test that will tell us if anyone is a good match for your child. Your child and any potential living donors will need to have this test done.

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)

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ABO Typing

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ABO typing determines 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

If a potential donor’s kidney does not match your child’s blood type, donation / transplantation may still be possible, for example, through a paired donation. Cincinnati Children’s Hospital Medical Center participates in such a program.

HLA Typing

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HLA stands for “human leukocyte antigen” and refers to the identification of specific transplant antigens (tissue markers) on the recipient’s and donor’s white blood cells and other cells.

Like blood type, 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 that 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

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In this test, your child’s blood is tested against 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.

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 blood and donor’s cells, is therefore typically necessary for the transplant to occur.

Other Evaluations

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After tissue typing has been completed, several other tests and evaluations are scheduled. These include:

Education session: The transplant coordinator will meet with you and your family to discuss all aspects of transplantation. You will be given written material about pre- and post-transplant information, medications, complications and follow-up care.
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 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 meet with the transplant surgeon to discuss the surgery, its risks and benefits and post-transplant recovery.
Anesthesia evaluation
Psychosocial evaluation: You and your child will meet with a social worker or psychologist to assess psychosocial barriers to transplant and identify any support services that need to be arranged prior to 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 you may experience both before and after transplant
Explore the potential for additional health coverage, if needed

Last Updated 06/2015