Can an Adult Donate a Kidney to a Child?

If you know a child who needs a kidney transplant and are considering donating a kidney, you may be wondering whether an adult can donate a kidney to a child.

The simple answer is yes—adults can and do donate kidneys to children. However, the process involves various medical and logistical considerations to ensure the safety and well-being of both the donor and recipient.

Every year, approximately 170 children aged 1–5 and 140 children aged 6–11 receive kidney transplants. Between 30% and 40% of the kidneys transplanted into children aged 1–11 are from living donors.

Kidney transplants from living donors, including adult-to-child transplants, generally have high success rates. Advances in surgical techniques and post-operative care have improved outcomes significantly.

A 2006 study found that living donor kidney transplantation was becoming more prevalent in pediatric patients, with excellent outcomes. The five-year patient survival rate was 96%, and graft survival has improved over the years, currently exceeding 95% at one year post-transplant.

Children who receive kidney transplants can lead healthy, active lives, and the new kidney can function well for many years.

Following are some of the key considerations in adult-to-child kidney transplants.

Kidney Size

While very young children and infants may face anatomical challenges due to their smaller size, in most cases, an adult kidney can be successfully transplanted into a child.

Kidneys from adult donors are typically larger than those from pediatric donors. However, a healthy adult kidney can still function well in a child. Surgeons are skilled at adjusting the placement of the kidney to ensure it fits properly.

Donor Age

More important than kidney size is the age of the donor. Many times, a parent, or even a grandparent, will want to donate directly to a child, but a direct donation from a much older person might not always be the best option.

Think about selecting a kidney like buying a used car. Choosing one with low mileage increased the chances it will last longer. The same is true of a kidney, particularly for children, because a young person who has a kidney transplant will very likely need another one at some point.

A 2020 study noted that transplanted kidneys don’t last forever, and children who need a kidney transplant in early childhood will probably have two or three kidney transplants in their lifetime.

If a child receives a “young” kidney from a donor closer to their age, they have a better chance for a positive long-term outcome, meaning the kidney will last for many years before it stops working and they need another transplant.

Getting the Best Match

When a child needs a kidney transplant, the adults in their lives are often eager to donate a kidney. In some cases, this can be an excellent solution because it prevents the family from having to wait for a deceased donor or search for a living donor. In addition, it may be deeply meaningful and emotionally fulfilling for a family member to give a child a chance at a healthier, longer life.

However, in addition to the age consideration described above, the most important thing is finding the best possible kidney match for the child. If a family member or friend is incompatible or not an optimal match, it makes more sense to find a better-matched donor through a program like paired exchange or the National Kidney Registry’s Voucher Program.

If you or someone you know wants to donate a kidney to a child, unless you are a perfect match, the best option is to donate through the NKR’s Standard Voucher Program. With the Standard Voucher Program, the donor donates at a time that works best for them. Their kidney is then matched with someone in need, and the intended recipient (the child) receives a voucher that can be redeemed for a future transplant. When the child is ready for a transplant, the NKR searches its large pool of living donors to find the best possible match.

Having the best possible match is the best way to ensure the transplant is successful and the kidney lasts as long as possible. In addition, if a child receives a well-matched kidney, their immune system is less likely to develop antibodies against the new kidney. This is because a strong match reduces the risk of sensitization, which occurs when the immune system recognizes the transplanted organ as foreign and produces antibodies to attack it. Being less sensitized makes it easier to find a compatible donor if the child needs a second transplant in the future.

If you or someone you know is interested in donating a kidney to a child, it is important to follow the guidance of the child’s medical team. They can provide expert guidance on whether the donor is the best match, ensuring the child receives the best chance for a successful transplant.