The Pediatric Kidney Transplant Program at St. Louis Children’s Hospital is run jointly by the Section of Transplant Surgery and the Division of Pediatric Nephrology of Washington University. The program provides comprehensive evaluation, treatment and on-going care for children with end-stage renal disease (ESKD), including cadaveric and living donor kidney transplantation.

Clinical activities

The first pediatric kidney transplant at Washington University Medical Center was performed at Barnes Hospital in 1964. The long-term survival of our patients and their transplants have steadily improved since the early years of the program, with five-year survival rates of >90% for living related donor kidneys, and >80% for cadaveric donor kidneys.

Children receive kidney transplants for end-stage kidney disease associated with a variety of conditions, including: congenital and hereditary kidney disorders, chronic urinary tract infections, chronic glomerular and tubular diseases, toxic exposures, polycystic kidney disease and kidney disorders secondary to systemic diseases such as systemic lupus erythematosus. Aside from the St. Louis metropolitan area, our regional referral area encompasses southern and eastern Missouri, southern Illinois, and northeast Arkansas. A separate kidney transplant clinic meets weekly for long-term management of pediatric kidney transplant recipients. All patients are reviewed in a multidisciplinary team meeting to develop treatment plans as well as to evaluate new referrals.

All patients referred for kidney transplantation undergo a comprehensive evaluation, with review of their medical history, assessment of their current medical condition and ongoing problems, as well as neuropsychological and psychosocial assessments.

Wherever possible, transplantation is performed before the initiation of dialysis in the treatment of end-stage kidney disease (pre-emptive kidney transplantation). We have extensive experience with both cadaveric donor and living donor (related as well as unrelated) transplants.

Ongoing research projects

  • NIH R01 support for randomized controlled trials to improve medication adherence in adolescents after kidney transplantation
  • NIH U01 support for prospective multi-center studies to improve post-transplant graft and patient survival and reduce morbidities
  • Long-term outcome and function of pediatric kidney transplant recipients
  • The role of CKD-MBD in chronic allograft nephropathy


  • North American Pediatric Renal Trials and Cooperative Studies (Registries of Transplant, Dialysis and Chronic Renal Insufficiency patients)

Online information sources/links

Information for parents and patients

Information for physicians and health care providers