Children's Hospital of Philadelphia's pediatric kidney transplant team will evaluate each child with advanced kidney disease to determine the need and best timing for transplant. The United Network for Organ Sharing (UNOS) is responsible for managing transplant organ distribution in the United States. UNOS oversees the allocation of many different types of transplants, including kidney, liver, pancreas, heart, lung, intestine and vascular composite allografts, such as upper limbs.

If your child is found to be a good candidate for kidney transplant and you decide you would like to pursue deceased donor transplant, your child will be placed on the UNOS kidney transplant deceased donor waitlist.

• UNOS maintains a national computerized list of children and adults waiting for kidney transplants.
• UNOS works with Gift of Life Donor Program, our local organ procurement organization, to recover deceased donor organs.
• Once active on the waitlist, your child will be eligible for organ offers.
• Inactive (Status 7): In some situations, our team makes children inactive on the waitlist for a period of time. You will be notified if your child is made inactive on the waitlist. During the time that your child is on the inactive waitlist, they will gain wait time but will not receive organ offers.
• Children younger than 18 years of age receiving additional priority on the waiting list.
• Anyone on dialysis receives waiting time retroactively from their dialysis start date if they are waitlisted after they started dialysis.

Kidney transplant waiting period

While you are waiting for a donor, the pediatric kidney transplant team will work to keep your child in the best possible health. Be sure to:

• Bring your child to all regular well visits and kidney transplant team appointments.
• See your pediatrician and/or let your child’s kidney doctor know if your child feels sick.
• Keep your child’s immunizations up to date. In some cases, especially with infants, vaccinations may need to be given ahead of the regularly recommended schedule, in preparation for kidney transplant.
• Should your child be exposed to any of the childhood diseases for which they haven’t been vaccinated, please contact the transplant coordinator.
• Stay in touch with the kidney transplant coordinator about any changes in your child's health.

The UNOS Donor Matching Process for Deceased Donor Organ Offers

The following results in an organ offer:

• CHOP will receive a notification that a kidney is available for one of our patients on the waitlist. A kidney is offered based on:

1. Donor/recipient blood type match and compatibility
2. Time on the waitlist

• The transplant nephrologist and surgeon review the information about the donor kidney and consider whether to accept the organ
• If our team accepts the organ, you and your family will be notified. The team will speak with you about the condition of the kidney and any risks of accepting the kidney for your child.

A transplant coordinator is always on call to receive offers for deceased donor kidneys. When your child is listed, we will make a plan to contact you if a kidney becomes available. The transplant coordinator must be able to reach you within one hour. We need to make sure that your child is available, not sick and does not have an infection.

A surgeon and nephrologist are available 24 hours a day, 365 days a year. We have several nephrologists and surgeons, and they are “on call” for transplants.

An organ is not guaranteed until final review by the surgeon.

If your child is on the CHOP waitlist but not cared for by a CHOP nephrologist, your child should be seen by a CHOP transplant nephrologist at least every three months.

Children can be listed in more than one area of the country. This may increase the chance of getting a deceased donor kidney sooner. We will explain more about this option at the transplant meeting.