Before a Transplant: Pre-Kidney Transplant Evaluation

Before undergoing a kidney transplant, the Pediatric Kidney Transplant Program team at Cincinnati Children’s will conduct a pre-transplant evaluation.

The evaluation will give transplant team members a thorough picture of your child’s overall health 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:

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, A, B, AB


A, O



B, O



O, A, B, 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.

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 your 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 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.

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

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 determine 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 be scheduled to 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 necessary support services to be arranged before transplant.

United Network for Organ Sharing

Learn about how United Network for Organ Sharing (UNOS) helps unite the transplant community to save lives through organ transplantation. Read More

Related Resources

Online Tool for Families


Cincinnati Children’s offers a secure online tool to help you manage your child’s health.  MyChart gives you access to your child’s medical record, allowing you to view test results, a list of medications, appointments, follow-up instructions, diagnoses and more. And you can send a message to your healthcare team between visits.

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