Pediatric Donation

Pediatric transplants differ slightly from other organ donations — as organ size is critical to a successful transplant, children often respond better to child-sized organs. 


More than 2,100 children under the age of 18 are on the national transplant waiting list.


27% of children waiting for an organ transplant are under 5 years old.

How many children require organ transplants? 

In 2023, more than 1,900 children received lifesaving transplants, matched from nearly 900 pediatric organ donors. Currently, there are more than 2,100 children on the national transplant waiting list. More than 500 children waiting for a donor organ are between 1 and 5 years old.

While the donors ranged in age from newborns to 17, most were between 11 and 17 years old — though in 2023, 99 pediatric organ donors were under the age of 12 months.

Every year, thousands of pediatric cornea and tissue donors help restore sight and save and heal lives.

What causes the need for pediatric transplantation?

Many of the conditions that prompt the need for transplant can occur as early as infancy — including heart issues like restrictive cardiomyopathy or liver diseases like biliary atresia. Other issues surrounding injuries or diseases may also occur during childhood.

A number of diagnoses and conditions may necessitate a pediatric transplant. Some conditions can be diagnosed by a pediatrician.

  • Kidney conditions, as determined by a pediatric nephrologist, can include acute kidney failure and chronic kidney disease.
  • Liver conditions, determined often by pediatric hepatologists, can include metabolic diseases such as Wilson’s disease and Types 1–4 of Glycogen storage disease, acute and and chronic hepatitis, intrahepatic cholestasis, obstructive biliary tract liver disease, traumatic and post-surgical biliary tract diseases, cirrhosis, Caroli disease, congenital hepatic fibrosis, cystic fibrosis, and Budd-Chiari. Biliary atresia is the most common liver disease to require a liver transplant in children.
  • Heart conditions, diagnosed by pediatric cardiologists, can include congenital heart disease and cardiomyopathy.
  • Lung conditions, diagnosed by pediatric pulmonologists, may include cystic fibrosis and pulmonary hypertension.

Children suffering from advanced intestinal disease often benefit from intestinal transplants or short bowel transplants to avoid or treat liver problems or to assist with total parenteral nutrition (TPN) when a child’s veins are too damaged for IVs.

More information on specific conditions for pediatric transplants can be found at UPMC Hillman Center for Pediatric Transplantation and the Mayo Clinic, which also list the types of conditions that require pediatric organ donations and the specialists involved in these processes.

How does the pediatric transplant waiting list work?

Organ size is critical to a successful transplant as children often respond better to child-sized organs. Although pediatric candidates have their own unique scoring system, children are essentially first in line for pediatric donor organs.

As with the national transplant waiting list, the size of the recipient’s body is taken into account along with the size of the donor organ in order to make the best possible match of donor to recipient. Very small children most often receive donations from other young people — although older children and adults can also be a good match.

It’s also possible for children to receive deceased or living donations of partial organs, such as a partial liver transplant.

  • Most children under the age of 1 are waiting for a liver or heart transplant
  • Most children ages 1–5 are waiting for a kidney, heart, or liver transplant
  • Most children ages 6–10 are waiting for a kidney or heart transplant
  • Most children ages 11–17 are primarily waiting for a kidney transplant

Children are also on the pediatric transplant waiting list for donor lung, intestine and pancreas.

Can my child register to be an organ donor?

Teenagers 15–17 years old may register their intent to be an organ, eye and tissue donor (you can do this while registering for your driver’s license at the DMV, here on or at!). However, until they are 18 years old, a parent or legal guardian makes the final donation decision. A parent or legal guardian must authorize an organ, eye or tissue donation for anyone under the age of 18.

National Pediatric Transplant Week

National Pediatric Transplant Week takes place the last full week of National Donate Life Month in April. It focuses on the powerful message of ending the pediatric transplant waiting list. Throughout Pediatric Transplant Week, clinical partners share patient stories (candidates and recipients); donor families whose children have saved and healed lives through organ, eye, and tissue donation are honored; and recipient families share their thanks and milestone celebrations.

Donate Life America (DLA) would like to thank the United Network for Organ Sharing (UNOS), the American Society of Transplantation (AST),  American Society of Transplant Surgeons (ASTS), International Transplant Nurses Society (ITNS) and Transplant Families for their partnership in developing and promoting National Pediatric Transplant Week.

National Pediatric Transplant Week is part of Donate Life America’s National Donate Life Month — observed in April each year, National Donate Life Month features an entire month of activities to help encourage Americans to register as organ, eye and tissue donors and to honor those that have saved lives through the gift of donation.

Children’s Books About Donation & Transplantation

Thank you to the authors who are using their artistic gifts to bring attention to donation and transplantation. Learn more about the authors who support Donate Life America through the sale of their books.

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