A kidney transplant is a procedure performed to replace non-functioning kidneys with a healthy kidney from another person. The donated kidney may be from a:

• Living related donor - a person who is genetically related to the recipient, for example, a parent or sibling

• Living unrelated donor - a person who is not a blood relative of the recipient, but is emotionally related, such as a family friend

• Good Samaritan donor - in very rare circumstances, a stranger may come forward to voluntarily donate a kidney

• Deceased donor - a person who has died, typically from a severe head injury, where the family has agreed to organ donation through the New England Organ Bank

Starting at the time of the kidney transplant, your child will need to take a combination of medications called "anti-rejection" or "immunosuppressive" medications to prevent rejection of the transplanted kidney. These medications must be taken every day for the rest of your child's life while they have the transplanted kidney.

A kidney transplant is an option for children who have serious kidney failure and will not be able to live without dialysis or a transplant. Some children with the following conditions may need a kidney transplant:

The majority of kidneys that are transplanted into children come from living donors. Family members who are a good match when their blood is tested, may be able to donate one of their kidneys. This type of donor is called a living related donor.

Someone who is not genetically related to the organ recipient, such as a close friend, may also be able to donate a kidney. This type of donor is called a living unrelated donor.

Our transplant surgeons have developed techniques that allow us to transplant kidneys from adults into even infants and small children.

Individuals who donate a kidney will be hospitalized for three to five days after the surgery, but will require three to four weeks for full recovery. After that they can return to their normal healthy lives without restrictions or limitations.

A deceased donor is a person who has died, has been declared brain dead, has no kidney disease, and has provided a kidney through the New England Organ Bank.

Being a donor for a kidney transplant is a voluntary decision, and as such minors under 18 years of age are not considered. The potential kidney donor must be of a compatible blood type and meet other matching criteria. We never put the donor's health at risk for the sake of the recipient. All donors must pass a comprehensive medical evaluation to assure they can donate the kidney without complications. The testing for living donors may take up to two to three months.

The United Network for Organ Sharing (UNOS) is responsible for deceased donor transplant organ allocation in the United States. UNOS oversees the allocation of most types of transplants, including kidney, liver, pancreas, heart, and lung.

UNOS receives data from hospitals and medical centers throughout the country regarding all adults and children who need organ transplants. The medical transplant team that currently follows your child is responsible for sending the data to UNOS, and updating them as your child's condition changes.

Criteria have been developed to ensure that all people on the waiting list are treated fairly. Once UNOS receives the data from local hospitals, people waiting for a transplant are placed on a waiting list. Criteria used in determining priority for allocation of kidneys to people on the waiting list include: time on the waiting list, the quality of the match between the donor and the recipient, and the distance between the donor and the recipient.

As a result of recent changes brought about by the advocacy of pediatric transplant programs such as Children's Hospital Boston, children under 18 years of age receive priority on the waiting list and should receive a transplant within weeks or months of being placed on the list. Because of the success of chronic dialysis, patients awaiting kidney transplant are generally not at immediate risk of dying, unlike other organ transplant candidates. Thus, the criteria that are used principally involve waiting time on the list, rather than medical urgency.