Kidney Transplant Program

What to Expect If Your Child Needs a Kidney Transplant

One way that Seattle Children’s helps your child and family through this challenging time is by helping you understand as much as possible about the transplant process.

You most likely have many questions about Seattle Children’s and how to prepare your child for their clinic visit. Get information about your child’s clinic visit, including: 

  • Important things to do before the clinic visit
  • Tips on helping your child feel more comfortable about the upcoming visit
  • Paperwork to bring the day of the clinic visit
  • Suggested questions to ask your child’s doctor
  • How to prepare for care at home
  • How does the transplant process start?

    We accept referrals from your child’s primary care doctor, a specialist or a case manager, or directly from you.

  • What happens before the transplant?

    Your child will receive a pre-transplant evaluation before we can begin working with the organizations that handle the organ donation process.

    We will review your child’s medical and surgical history and schedule office visits with the transplant doctor and transplant team. The office visits usually take place over 2 days.

    Once the pre-transplant evaluation is complete, the transplant team will review your child’s case and determine if a kidney transplant is the best option for your child. If you and the transplant team decide to move forward, we can begin working with the organizations that handle the organ donation process.

  • What happens once the decision to transplant is made?

    If you have a family member or other living donor who is willing to donate a kidney, that person will be evaluated at University of Washington Medical Center (UWMC).

    If the donor is a good match, the donor’s surgery will be performed at UWMC, just 2 miles away from Seattle Children’s. Once the kidney is removed from the donor, it will be quickly transported from UWMC to Seattle Children’s for your child’s transplant.

    If the donor is not a good match for your child, we partner with the National Kidney Registry (NKR) to look for a paired exchange. This means NKR tries to match your willing donor to a different patient and to match a different living donor to your child. Your transplant coordinator or nephrologist can explain more about this option. Learn more about NKR.

    If there is not a living donor available, your child will be placed on the United Network for Organ Sharing (UNOS) waiting list for a kidney from a deceased donor.

    UNOS is a nonprofit organization that matches organs with patients. They collect information about every transplant in the United States.

    There are many things to keep in mind while you are waiting for a kidney transplant.

  • What happens during the transplant surgery?

    Preparing your child and your family for the surgery may help reduce everyone’s stress during this time.

    Our team will help your family prepare and cope with the experience. We want you to know what’s going to happen each step of the way.

    Learn more about what to expect if your child is having surgery, including: 

    • What to do once surgery is scheduled
    • Tips to help your child feel more comfortable about the surgery
    • What to bring the day of the surgery
    • What to expect the day of the surgery
    • Helpful questions to ask your child’s doctor
    • How to prepare for care at home 

    Most kidney transplant surgeries last about 4 to 6 hours. During surgery, you will be asked to check in at the Neonatal Intensive Care Unit (NICU) on the 6th floor and be given a pager so that staff in the operating room can keep you informed on how your child is doing.

    There are many comfortable places to wait at the hospital while your child is in surgery.

  • What happens after the transplant?

    Patients begin their recovery in the Pediatric Intensive Care Unit (PICU), where we closely monitor how the transplanted kidney is working. Transplant immunosuppression medicines are also started at this time. Most patients stay in the PICU for 2 to 3 days and then are moved to the Surgical Unit.

    Learn more about your child’s stay at Seattle Children’s, including: 

    • Things to do before your child’s hospital stay
    • Preparing your child for a hospital stay
    • What to expect during your child’s stay
    • Helpful questions to ask your child’s doctor
    • What to know after your child leaves the hospital 

    See our Hospital Campus Visitor and Family Guide, which includes: 

    • Services at Seattle Children’s
    • Surrounding neighborhood, including where to stay or to eat 

    Once your child leaves the hospital, they will continue to visit the clinic for follow-up care. A regular schedule of visits will make sure that your child:

    • Is recovering from surgery
    • Has no signs of infection or organ rejection
    • Is taking their prescribed medicines
    • Is returning to everyday activities
  • Who will we see in the Nephrology Clinic?

    Your child will be cared for by the same team of doctors, nurses and specialists before, during and after transplant. Our skilled team of specialists includes:

    Pediatric transplant surgeons

    Doctors who perform transplant operations on children

    Pediatric nephrologists

    Doctors who care for children who have diseases of the kidney

    Pediatric urologists

    Doctors who treat children with urinary problems

    Pediatric anesthesiologists

    Doctors who give children medicine during surgery to control pain and movement

    Physician assistants

    Healthcare providers who are licensed to practice medicine under supervision by a doctor

    Advanced registered nurse practitioners

    Nurses with master’s degrees who take primary responsibility for the care of their patients

    Registered nurse coordinators

    Nurses who coordinate who your child will see during clinic visits


    Ensure your child gets the nutrition they need for growth and development


    Prepare medications prescribed by doctors and tell you about a medicine’s purpose, effectiveness and side effects

    Social workers

    Help families understand and address the emotional and practical aspects of medical care

    Child life specialists

    Work with patients and families to help reduce anxiety, develop positive coping skills and adjust to the hospital experience; also provide information about play, child development and adjustments to illness

    Transplant specialists

    Schedule visits and help patients and families manage insurance coverage and finances