During the last 14 years, since the opening of the Center for Childrens' Hemodialysis the University Children's Hospital of Belgrade, 174 children with terminal renal failure were treated by chronic hemodialysis. Of these, only 35 patients (20.1%), 14 girls and 21 boys, mean age 12.6 +/- 4.9 years, were transplanted. The average waiting time for transplantation was 24.6 months (range 0-120 months). Twenty-five patients were transplanted with paternal kidney, the others were cadaveric transplantations. More than half of transplantations were done abroad. Of 35 patients, 20 were under follow-up for over 6 months (45.7 +/- 7.2 range 6 to 102 months). Five year patient survival was 94.1% and the graft survival over the same period was 76.4%. 45.7 +/- 7.2 months after transplantation the outcome was the following: 11 patients (55%) had GFR over 60 ml/min/1.73 m2, 5 patients (25%) had GFR from 25 to 60 ml/min/1.73 m2, 2 patients (10%) returned to chronic hemodialysis, 1 patient was retransplanted and 1 patient died. All patients with GFR of over 60 ml/min/1.73 m2 are well psychosocially rehabilitated, 62.4% are normotensive without antihypertensive therapy, and only 9.9% are growth retarded.