Pediatric kidney transplantation part 14

Those doctors will make sure your child's other organs are working well and that your child can safely undergo anesthesia for the transplant operation. Some centers will also have your child be seen by an infectious disease specialist.

The "palliative care team" is another important team that is often included. This team helps you make decisions that are best for your child and your family.

In addition to determining your child's medical eligibility for transplant it is also the responsibility of the transplant team to assess ability to adhere to a complex treatment regimen. This can be particularly hard for teenage transplant patients and is frequently one of the most difficult challenge after transplant. Non adherence with medications and a  sometimes demanding visit and lab schedule after transplant can threaten the health and well-being of the transplant and the patient. The transplant team will likely take any concerns in this area very seriously and work with you to offer ways to increase the likelihood of success after transplant

Pediatric kidney transplantation part 13

Medical consult (as needed)

Your child will also see doctors in the hospital such as:

• An anesthesiologist (the doctor who gives your child sleep medication before an operation)
• A cardiologist (heart doctor)
• A hepatologist (liver doctor)
• A pulmonologist (lung doctor)
• A neurologist (nervous system doctor)
• A gastroenterologist (stomach doctor)

Pediatric kidney transplantation part 12

Interdisciplinary team assessments

These involve meeting and tests with different health care professionals, such as :

• Urologist
• Pediatric urologist
• Pediatric transplant surgeon
• Transplant nurse coordinator
• Transplant pharmacist
• Financial representative
• Physiotherapist
• Occupational therapist
• Dietitian
• Social worker
• Child family life specialist
• Pysicologist or neuropsycologist
• Pediatric dentist
• Psycologist/psychiatrist

Again, whether your child will meet all these professionals depends on their personal situation and where they are being assessed.

Pediatric kidney transplantation part 11

MEDICAL TESTS

Tests on other parts of the body

These can include:

• Chest radiograph
• 12-lead electrocardiogram
• Peritoneal fluid (cell count and differential, culture if patient is  on peritoneal dialysis)
• Ultrasound of the native kidneys with doppler (to assess blood flow to the inferior vena cava and to rule out thrombosis)
• Voiding cystourethrogram (to evaluate for urethral patency, vesicoureteral reflux and residual urine volume)
• Pap smear if  a female adolescent is or has been sexually active

Pediatric kidney transplantation part 10

MEDICAL TESTS

Other tests

These include:

• Complete blood count with platelets
• Chemistry profile including electrolytes, blood urea nitrogen, creatinine, calcium, phosporus, intact parathyroid hormone concentration
• Complete liver function tests, including serum liver enzymes, bilirubin, albumin, cholesterol and triglyseride concentration
• Coagulation profile including an internationel normalized ratio and partial parathrombin time (to screen for coagulation abnormalities), homocystein level, factor V leiden and parathrombin 2 tests
• Viral serology tests, including those for hepatitis A,B, and C; cytomegalovirus, Eipstein-Bar virus, varicella zooster, measles, mumps and rubella, herpes simplex, anti treponema EIA and human immunodeficiency virus
• Tuberculosis testing

Pediatric kidney transplantation part 9

MEDICAL TESTS

Blood tests

These include tests to identify your child's:

• Blood group (ABO typing)
• Levels of anti-human leukocyte antigen (HLA) antibodies and how strong they are. HLA antibodies are antibodies that your child has in their body that may attack someone else's kidney. This testing helps the transplant team determine if your child has a higher risk of rejection. It also helps predict if your child might have to wait longer for a donor kidney because having these antibodies may make it harder to find a suitable matching donor

Pediatric kidney transplantation part 8

How is my child asessed for kidney transplantation?

Your child will have a number of medical tests, and you will be asked questions about your child's medical history by different members of the transplant team. You can also ask questions of the team.
The evaluation have several purposes including establishing or confirming a diagnosis through review of medical records and biopsy material and assessing the complications of chronic kidney disease. Most patients have their assessment as an outpatient of the hospital over one or two weeks. This means they have appointments in the hospital but do not stay overnight.

The results of the tests will give an idea of your child's overall health. The tests your child will have may depend on:

• Their age
• What is wrong with their kidneys
• How long they have been sick
• How sick they are
• Whether they have been seen at the transplant center before