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Pediatric Kidney Transplantation at Mass General for Children 

We know that this is a very stressful time, and we are dedicated to providing an open, welcoming environment for you and your child. We believe that no one knows a child as well as a parent—parents, along with primary care providers, are our partners in a child's care and have an active voice in all treatment plans. 

Our team will guide you and your child through the transplant journey every step of the way, with a goal to improve your child's health as quickly as possible so they can get back to doing the things they love. 

As a patient and caregiver, you can expect: 

  • A care team that champions a multidisciplinary and family friendly approach to optimize and individualize the care of each child
  • A program that is uniquely equipped to facilitate adult-to-child living donation with adult and pediatric operating teams working in adjacent operating spaces 
  • Support throughout the entire transplant journey, from infancy through adulthood 

Our Multidisciplinary Team 

With more than 40 years of experience in pediatric transplantation, the Pediatric Kidney Transplant Program at Mass General for Children is a major referral center for children with chronic kidney disease (CKD) that has progressed to end-stage kidney disease (ESKD), or pediatric kidney failure. Our multidisciplinary team—which includes expert pediatric transplant surgeons, nephrologists, coordinators, pharmacists, social workers, and nutritionists—is at the forefront of pediatric kidney transplantation and works to ensure optimal treatment before, during, and after surgery. 

This team operates as part of the comprehensive Transplant Center at Massachusetts General Hospital, which means that our team is uniquely suited to caring for your child as they grow up and transition from pediatric care to adult care. We offer leading-edge consultative services, treatment, and surgical interventions to adult and pediatric patients with a broad spectrum of diseases. 

How to Request a Consultation  

If your child is already a patient at MGfC, please call the transplant coordinator at 617-724-1218 to request a consultation, or ask your child's pediatrician or nephrologist to do so on your behalf. A pediatric kidney transplant nurse coordinator and nephrologist will review your child’s medical records once they have been received. Our staff will then schedule an initial evaluation appointment. 

New patients must register and obtain a Mass General Medical Record Number before an appointment can be made. To do so, please call the Mass General Registration and Referral Center at 866-211-6588. The center is open Monday through Thursday, 8:00 am to 6:00 pm EST, and on Friday from 8:00 am to 5:00 pm EST. Please have your insurance cards and primary care provider information available when you call to register. 

Learn more about kidney transplant at MGH 

Options for Receiving a New Kidney 

Donor Waitlist

Once candidacy for transplant is approved, patients are added to a deceased donor waitlist managed by the United Network for Organ Sharing (UNOS). UNOS gives priority to patients based on waiting time, with retroactive time awarded if dialysis was started before listing. 

Living Donor Kidney Transplant

Living donation, when possible, is a good alternative to deceased donation. Nearly half of the kidneys transplanted at Mass General are given by living donors. Our program is uniquely equipped to facilitate parent-to-child living kidney donation, with adjacent operating room space and adult and pediatric providers that closely collaborate in your child’s care. 

Learn more about living donor kidney transplant 

Living Kidney Donor Roadmap (PDF)

Transitions and Peer Connections Programs 

Maturing from childhood to adulthood can be challenging, especially for children with chronic health conditions. Due to their medical issues, many adolescents and young adults with kidney transplants have had limited opportunities to practice independence. 

Our Transplant Transitions Program leaders work with each patient to educate, coach, and provide support tailored to each individual. Our Peer Connections Program is a key component of this program, pairing teens and young adults with peers to share experiences, understand challenges, and celebrate accomplishments. Successful transitions can happen when pediatric patients understand their medical situation (know their diagnoses, medications, care providers, pharmacies, and insurance providers) and learn how to advocate for their medical needs with employers and educational institutions. 

When the time is right, and in partnership with the adult team, we coordinate a patient’s transition from the pediatric team to adult care. 

Frequently Asked Questions About Pediatric Kidney Transplant

What causes kidney failure in a child?

Kidney failure, or end-stage kidney disease (ESKD), typically happens for different reasons in children than adults. 

The most common causes for pediatric kidney failure are: 

  • Birth defects that may result in lack of healthy kidney formation and function, restricted blood flow, or chronic infection 
  • Genetic, or inherited, diseases such as polycystic kidney disease 
  • Kidney infections, which can sometimes produce an inflammatory response that causes damage to the kidneys 
  • Systemic diseases, which affect other organs in the body 
  • Kidney trauma or injury that cause a sudden and severe decline in blood flow to the kidneys 

The most common causes of pediatric kidney failure often depend on the child’s age: 

  • Birth to age four—kidney birth defects (congenital) and genetic diseases 
  • Age five to 14—genetic and systemic diseases 
  • Age 15-19—damage to the blood vessels in the kidney (glomeruli)
What are the symptoms of pediatric kidney failure?

Diagnosis of pediatric kidney failure is challenging. If the cause is hereditary or congenital, chronic kidney disease may be caught while your baby is in utero. For children, chronic kidney disease often does not cause distinct symptoms. 

If symptoms are present, they may include: 

  • Flu-like symptoms, such as fatigue and fever 
  • Decline in school performance due to lack of concentration 
  • Swelling of the hands, feet, or area around the eyes 
  • Change in frequency or color of urination 
  • Loss of appetite 
  • Headaches due to high blood pressure 
  • Stunted growth 
How effective is pediatric kidney transplantation?

Kidney transplant is the recommended and best treatment for children with end-stage kidney disease. At Mass General for Children, you and your child have access to the latest surgical techniques and a highly specialized, multidisciplinary team—this means that your child has an excellent chance for a much-improved quality of life and long-term survival following transplant surgery versus. 

How long does my child need to be on dialysis?

Dialysis is a therapy for patients with end-stage kidney disease and can keep them alive while they are waiting for kidney transplantation, but not all children require dialysis before getting a kidney transplant. Whether or not a child needs to start dialysis prior to transplant surgery depends on their condition—the length of time they spend on dialysis depends on their age and when a kidney becomes available. 

Your child’s doctor will determine if dialysis is needed or if your child can progress to transplant right away (pre-emptive transplant). 

How long will my child have to wait for kidney transplantation?

The length of time that your child awaits transplant depends on how quickly their kidneys are failing and the ability of a donor organ. If your child is receiving a new kidney through living donation, it can be a matter of weeks after the potential donor is approved, and your child’s nephrologist determines that their kidney disease has progressed enough to proceed with transplant. If they are receiving a new kidney through the donor waitlist, it could take longer to find a good quality kidney for your child. Kidney transplant candidates are ranked by wait time, but UNOS prioritizes children for good quality kidneys to help decrease the time that children have to wait.

Where will my child’s new kidney come from?

Donor kidneys come from one of two places: 

  • A living donor. In this case, a healthy, living person can choose to donate one of their kidneys to someone with end-stage kidney failure. Donors are able to live normal, healthy lives with their remaining kidney. Learn more about living donor kidney transplant > 
  • A deceased donor. Your child may receive a new organ through the donor waitlist. In these cases, the donor is someone who has recently passed away and previously elected to become an organ donor after death. 
Can I donate a kidney to my child?

A healthy person can choose to donate a kidney to a child they know personally (directed donation) or to a stranger (nondirector or altruistic donation). This is called living donor kidney transplant. Living donation offers many benefits to the child such as reducing wait time, scheduled surgery, and more. 

Do I have to be related to the child to donate my kidney to them?

You do not need to be related to the recipient in order to become a living kidney donor. Becoming a living kidney donor starts with an evaluation to determine compatibility. Our transplant coordinate team will guide you through the process. 

Become a living kidney donor 

What happens after my child’s kidney transplant operation?

Children who undergo kidney transplantation often feel an improvement soon after surgery. Kidney transplant recipients stay in the hospital anywhere from three days to two weeks or more after surgery, depending on their individual recovery speed and the ability of family to take care of the child at home. 

Before going home, your Mass General for Children transplant team will prescribe your child medications to help manage their pain, avoid infection, and prevent kidney rejection. Medication to prevent organ rejection is needed every day, and parents will receive information from our team to help their child manage this important part of their post-transplant care, as well as other important tips for caring for a transplant. 

Your team will inform you how often your child will need to receive check-ups to ensure the transplanted kidney is functioning properly. Typically, frequent check-ups are needed in the year following surgery. However, if there are no complications, the frequency decreases with time. 

Meet the Team

At Mass General for Children, your child will be cared for by a team of specialist experts in pediatric transplantation, including pioneers in the field. Our multidisciplinary staff includes pediatric transplant surgeons, infectious disease specialists, nephrologists, urologists, psychiatrists, nurses, social workers, case managers, and nutritionists.

Kidney Transplant Staff 

  • Rachel Ritter, MSN, RN—Pre-Transplant Coordinator 
  • Linda Mazzola, BSN, RN—Post-Transplant Coordinator 
  • Barb Luby, LICSW—Social Worker 
  • Jessica Witchey, RD-AP, LDN, CNSC—Dietician 
  • Caitlyn Ann Keish—Patient Services Coordinator 

Patient Resources