Organ transplants in children

I have dealt with pediatric solid organ transplantation quite a bit over the years, both from the perspective of caring for children who receive transplants and for those unfortunate children whose parents choose for them to become organ donors. By solid organs I mean primarily kidney, liver, heart, and lung transplants–bone marrow transplants are somewhat different. Children comprise a small but significant subgroup of organ transplant patients: in a recent survey they accounted for 7% of transplant recipients, a number which had changed little in the previous decade.

Although children accounted for 7% of the recipients, they comprised twice that number of donors–14% of them. Some transplanted organs may come from a living donor; for example, about half of kidney transplants use an organ donated by someone, usually a close relative. (This is possible because we have two kidneys and can live quite normally with only one of them.) Children, however, are not living donors. This means all of those children who donated organs died, and their families made the choice for their child’s organs to live on and give life to another person. And that person was often an adult, because the number of children who donate organs far exceeds the number who receive them as transplants. We do try to match donated organs from children first with another child, particularly if size is important, as it often is for the very small children. But if no child is a match, and size is not an issue (it often is not if the donor is an older child), the organs are given to adult patients.

I have many times been in the position of asking grieving parents to consider donating their beloved child’s organs to another person. I could not find any national statistics about this, but in my personal experience, two-thirds at least of parents I ask make the choice to donate life. I do know the donation rate for adults is far, far lower than that. Children on the whole have healthier organs, and this is reflected by the fact that children who donate are more likely than adults to be able to donate several organs, often three or more. But this is not the reason children represent such a relatively large proportion of organ donors; the reason is their parents, however devastated by the loss of their child, choose this for them. We adults should be so generous with our own bodies.

If you are interested in learning more about transplantation in general, this is a good site with useful links to other authoritative sites. If you want to know more of the technical specifics of children’s transplant statistics over the past decade, you can read about it here.

I have a donor’s heart logo on my driver’s license. I encourage everyone to think deeply about doing that, too, as well as telling your family that, should tragedy strike unexpectedly, you wish your organs to live on in someone else.


8 responses to “Organ transplants in children”

  1. Chris, those conversations with parents must be among the most difficult aspects of your job. God bless them for making the selfless choice in their hour of grief.

  2. It’s difficult, I suppose, but mainly it’s rewarding. Given the chance, most people really do the right thing. One thing I’ve learned is never to underestimate people. It’s rewarding to see that happen.

  3. Can an 18 year old donate to an 8 year old brother?

  4. Maria — I assume you’re talking about kidney donation, and the answer is nearly always yes (assuming the immunologic match between the brothers is a good one). Although there is some size difference between those two ages, it nearly always doesn’t matter.

  5. can a child recieve an adult organ.

  6. Hi Donney:

    In many cases, yes. An adult kidney will often work for a larger child, and portions of an adult liver can be transplanted into a child. Hearts and lungs, though, need to be matched more closely in size between donor and recipient.

  7. Nikiya Avatar

    I saw that an adult kidney would work for a larger child, but could a child donate a heart or kidney to an adult if they were close in size? For instance a tall 10 year old boy to a petite 20 year old woman? Does it matter that the heart and kidney is only 10 years old, etc?

  8. Size is what matters with hearts, not so much age. Kidneys have more range. For example, two child kidneys can be transplanted into an adult.

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