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    • PEDIATRIC KIDNEY TRANSPLANT PROGRAM

    We are pioneers in liver transplant for pediatric patients in Puerto Rico, offering hope
    and specialized care to our patients and their families.
    Medical Faculty

    When Does a Child Require
    a Kidney Transplant?

    A kidney transplant is considered when a minor’s kidney
    function has been below 20% (GFR under 20mL/min/1.73m2),
    for a period of over 3 months, which is known as advanced
    chronic kidney disease or end-stage renal failure. 

    If the patient is not undergoing dialysis, their eGFR must be
    under 30 in order to be considered for a transplant.

    Most common causes in children and adolescents:

    • Kidney and urinary deformities (for example,
      posterior urethral valves, renal dysplasia).
    • Genetic diseases such as Alport Syndrome
      or polycystic kidneys.
    • Glomerular diseases (these affect the kidneys’
      filters), such as Resistant nephrotic syndrome
      or IgA nephropathy.
    • Secondary renal damage, recurrent urinary
      infections, or systemic diseases.

    If your child presents any of these conditions,
    their pediatric nephrologist must refer them to our
    Pediatric Kidney Transplant Program for evaluation.

    Benefits of a
    kidney transplant:

    Better physical growth and development.

    Lower risk of complications associated
    with prolonged dialysis.

    More energy for participating in school and
    recreational activities.

    Higher quality of life for the child
    and their family.

    EVALUATION PROCESS

    Your child will be examined by a multidisciplinary team that includes:

    Pediatric Nephrologist

    Transplant Surgeon

    Cardiologist

    Urologist

    Infectious Disease Specialist

    Psychiatrist

    Social worker

    Dietitian

    Dentist

    Financial coordinator

    Other specialists, according
    to the patient’s clinical condition

    Studies

    Blood tests to detect infections and determine
    compatibility with donors, among others.

    Diagnostic studies such as X-rays, ultrasound,
    echocardiogram, urology tests, among others.

    Case Review

    When all evaluations are completed, the case
    is presented to the Selection Committee.

    SELECTION COMMITTEE

    This committee is made up of a transplant coordinator, pediatric hepatologist,
    transplant surgeon, social worker, financial coordinator, dietitian, psychiatrist
    and pharmacist – those who have participated in the evaluation.

    The purpose of this committee is to review all medical and social information in
    order to decide whether a transplant would be safe and beneficial to the patient
    and coherent with medical and psychosocial criteria previously established.

    Not all children are compatible with a kidney transplant.
    Some of the most common reasons why this may be true are:

    Serious diseases that could not heal post-transplant

    Current or chronic infection that cannot be controlled

    Metastatic cancer (when cancer has reached other parts of the body)

    TYPES OF
    KIDNEY DONORS

    If your child is not accepted as a candidate for transplant, they may receive a kidney transplant from one of the following donors:

    Live donor: A compatible family member or friend may become a donor. This allows for the surgery to be planned and for transplant wait times to be reduced. Parents, siblings and other family members are typically the first to be evaluated.

    Live Donation

    Waitlist (deceased donor): If there are no compatible living donors available, the patient is put on a waitlist, submitting their medical information to UNOS (United Network for Organ Sharing), the organization in charge of administering the national waitlist for organ donations based on compatibility and medical urgency. Once there is a possible donor for your child, our team will reach out to your family immediately. If your child is not hospitalized, they must be taken to the hospital as soon as possible in order to prepare the child for the transplant surgery.

    Follow-up and
    care after a transplant

    Hospitalization after a transplant: Generally lasts between
    5 and 7 days, depending on the patient’s progress.

    Follow-up after a transplant:

    • Frequent visits to the hospital for laboratory tests and medical evaluations.
    • Daily immunosuppressant medication to avoid rejection.
    • Continual education for the parents and caregivers regarding medication, warning signs, and home care.
    • Emotional and psychosocial support for the entire family.

    Long-term commitment: the transplant’s success depends on
    strictly adhering to treatment and medical follow-up.

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