Pediatric organ transplantations

​In Finland, pediatric organ transplantation operations have been centralized to the New Children’s Hospital. By 2015, over 500 children and adolescents had received a transplanted organ. By international comparisons, the results of pediatric organ transplantations are excellent in Finland, with 70–90 % of the patients surviving. A child who has received a transplant requires life-long antirejection medication but otherwise, his or her everyday life corresponds to that of other children of the same age. After the transplantation, the growth and development of the children and adolescents is mainly normal and the quality of life is good.

Causes for pediatric organ transplantations differ from those for adults. In many cases, the cause is a congenital defect or disease, in which case the need for a transplant becomes evident as early as the first months of life. A transplantation is the last treatment method for an incurable disease.

In the main, organs harvested from adults are used for pediatric organ transplantations. This poses demands on the quality of the transplants because the child is expected to live for a long time with the transplanted organ.

In the case of renal transplantations, one of the parents can act as a donor and attempts are made to increase the number of family donors. The lack of a kidney will not cause health problems for the donor. In liver transplants, the adult liver can be reduced to suit a small child.

Since the donor and recipient must be roughly the same size for a heart-lung transplant, waiting times for a small child are often lengthy. If there is little time left, cardiac function can be supported with an artificial heart for a couple of months while waiting for a transplant.

In some cases, several organs may need to be transplanted simultaneously. These include a heart-lung transplant, liver and kidney transplant and liver and intestine transplant.

Renal transplantations
The first pediatric renal transplantations took place in Finland in 1986. The most common causes for a renal transplantation include congenital severe proteinuria (CNF, Finnish-type nephrotic syndrome), congenital malformations of the urinary tract and other congenital diseases.

Liver transplantations
The first pediatric liver transplantations were performed in 1987. In addition to hepatitis, the most common causes for a liver transplantation include biliary atresia, metabolic diseases and liver cancer.

Heart transplantations
In Finland, the first pediatric heart transplantation was performed in 1991. The most common causes for a heart transplantation include congenital heart diseases and cardiomyopathy.

Lung transplantations
The first lung transplantation was performed in 2007. Causes for pediatric lung transplantations can include severe cardiac defect, disease of the pulmonary circulation or cystic fibrosis.

Intestinal transplantations
The first intestinal transplantation in Finland was performed at the Children’s Hospital in 2009. In addition to tumors, the most common diseases requiring an intestinal transplantation include short-bowel syndrome, disturbances of intestinal mobility and rare intestinal mucosal diseases.

Patient organization

Organization for kidney and liver patients (in Finnish)