Indications and Contraindications for Pediatric Transplantation

Referral Criteria for Pediatric Kidney Transplantation

We welcome a call from physicians who are interested in discussing pediatric transplantation or potential indications or contraindications for a specific patient.  If you are a medical professional calling from a physician's office and would like to reach a Hopkins transplant physician, please feel free to reach us using any of the numbers listed below:

Pediatric Kidney Transplantation Office (Monday-Friday, 8am? – 4pm?) 410-955-1247 or Hopkins Access Line for Physicians (24 hours, 7 days a week) 410-955-9444 or 1-800-765-JHHS

The Kidney Transplant Program offers a multidisciplinary approach to the evaluation and selection of patients for its transplantation program.  Physicians, transplant nurse coordinators, social workers, counselors and other professionals from numerous disciplines at the Johns Hopkins Hospital.

Patient Selection Criteria

Any condition that results in end-stage renal disease, including, but not limited to:

• Congenital renal obstructive disorders including:
• Ureteropelvic Junction Obstruction (UPJ)
• Vesicoureteral Reflux
• Posterior Urethral Valves (PUV)
• Prune Belly syndrome
• Megaureter
• Congenital Nephrotic syndrome
• Alport syndrome
• Nephropathic and juvenile cystinosis
• Polycystic kidney disease
• Nail-patella syndrome
• Glomerulonephritis
• Berger disease
• Henoch-Schonlein Purpura (HSP)
• Hemolytic Uremic syndrome
• Wegener granulomatosis
• Goodpasture syndrome

Absolute contraindications for children include, but may not be limited to:

• Advanced cardiopulmonary disease
• Active malignancy with metastises
• Severe local or systemic infection
• Untreatable neurologic deficits
• Active substance abuse
• Untreatable psychiatric illness
• Relative Contraindications for children include, but may not be limited t
• Multiple urinary tract reconstructions
• Neurogenic bladder
• Lack of family or social support
• Severe malnutrition/cachexia
• Evidence of significant non-adherence

High Risk Factors:

These factors are evaluated on a case-by-case basis and do not necessarily preclude transplantation.

• Hepatitis
• Small size
• Complex genitourinary anomalies
• Neurogenic bladder
• Ileal loop
• Multivisceral transplant
• Periperal vascular disease
• Age less than 1 year

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Other links in Pediatric Transplant site:

Transplant Team
Information for Healthcare Professionals
Referring Physician Checklist