V O L . X V, 2 0 2 6
THE ART AND SCIENCE OF MEDICINE
Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
BarnesJewish.org/Curiosus
THE ART AND SCIENCE OF MEDICINE
Our goal is simple: the best possible outcome for every patient, every time. Reaching for that goal requires addressing the individual needs of each patient while also providing compassionate care grounded in the latest research discoveries. This is possible only through a commitment to collaboration among our physicians, scientists, surgeons, nurses, and technicians who are leaders in their fields. Washington University Medical Campus is home to BJC HealthCare’s Barnes-Jewish Hospital and St. Louis Children’s Hospital, as well as the main campus of Siteman Cancer Center. WashU Medicine physicians provide world-class care at each of these locations. Because we all work together on this campus, our experts can offer a seamless experience for everything from the most common to the most complex conditions. Our patients trust us to offer the latest, science-backed treatments delivered by people who care for—and about—them. That is academic medicine in action. The outcomes we achieve demonstrate how the aligned vision between our teaching hospitals and WashU Medicine elevates everything we do—for our patients and for the future of medicine.
Cover photo by Sara Shakeel Studios
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kyoor-ee-OH-sus; Latin; adjective Eager to learn or know; inquisitive TABLE OF CONTENTS
Up Front
In Focus
In Depth
3 | Making Connections
Options for 14 | More Blood Cancer Patients,
Face: Advanced 30 | Saving Facial Reconstruction After
Medicine 20 | Moving Forward: Milestones in
Transplantation at 36 | Heart WashU Medicine and
WashU Medicine 4 | Bench: Breakthroughs From the Lab
Improving Survivability
Transplantation
Breakthroughs 9 | Bedside: in Patient Care Advanced Scanning Technology Enhances Medical Decision-Making, page 10
25 | Q&A The Fetal Care Center:
A Model of Innovation Through Collaboration
Trauma
St. Louis Children’s Hospital: National Reputation, Local Impact
Heart Disease 42 | Congenital and the Pediatric-to-Adult Care Gap
Laser Corpus Callosotomy for Medically Refractory Epilepsy, page 12
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CONTRIBUTORS Cheryl Alkon
Cheryl Alkon, MSJ, is a seasoned health and medical writer, researcher, and editor. She has written for physicians and patients for various publications, associations, and health care systems, and is the author of Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby. Tim Fox
Tim Fox writes long- and short-form nonfiction, as well as poetry and memoir. In 2022, the Missouri Historical Society Press published his book celebrating the 50th anniversary of the Metropolitan Zoological Park
and Museum District. He enjoys the challenge of making complex topics more accessible to all. Darcy Lewis
Chicago medical journalist Darcy Lewis, a former National Cancer Reporting Fellow, has written for AARP, Scientific American, Everyday Health, Cancer Today, Heart Insight, and many other publications. Her writing has won awards from the American Society of Journalists and Authors, the National Multiple Sclerosis Society, and Chicago Women in Publishing. In addition to writing, her passions include teaching and performing classical music.
Barnes-Jewish Hospital is a nonprofit academic medical center and the largest hospital in Missouri. Among the nation’s best on the U.S. News & World Report Best Hospitals list, Barnes-Jewish is nationally ranked in 10 specialties and is No. 1 in St. Louis and Missouri. Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet® hospital for nursing excellence. Barnes-Jewish Hospital is a member of BJC HealthCare, one of the largest nonprofit health care organizations in the United States. St. Louis Children’s Hospital is part of BJC HealthCare and has provided exceptional care for children from all 50 states and 80 countries around the world for more than 140 years. With its academic partner, WashU Medicine, St. Louis Children’s is consistently ranked among the nation’s best pediatric hospitals by U.S. News & World Report and earns national distinction for comprehensive services that include heart, cancer, neurology, and orthopedics.
Pam McGrath
Pam McGrath, a St. Louis resident, is a communications professional with 39 years of experience, the past 28 as a freelance writer and editor. Her articles have appeared in magazines published by leading health care systems, as well as schools of medicine and nursing. Pam also is a member of Allegro: A St. Louis Choral Community, and she volunteers with Second Chance Ranch, a rescue dedicated to caring for homeless, neglected, and sick senior dogs. Stephanie Stemmler
Based in St. Louis, Stephanie Stemmler is a freelance writer
with more than 35 years of experience in communications, including work as a television reporter and magazine writer, and as a public professional for hospitals and academic medical institutions. Always curious, she approaches story-writing as she does guitar-playing and quiltmaking, by seeking unexpected and surprising insights. WashU Medicine Science Writers
Shawn Ballard, Mark Reynolds, Kristina Sauerwein, Julia Evangelou Strait, Marta Wegorzewska
St. Louis Children’s is among an elite group of pediatric hospitals worldwide that have achieved a fifth consecutive, four-year Magnet Distinction® designation by the American Nurses Credentialing Center. St. Louis Children’s is also one of the few pediatric hospitals in the Midwest nationally recognized by the American College of Surgeons as a Level 1 Pediatric Trauma Center.
in Missouri and southern Illinois. WashU Medicine physicians also treat patients at BJC’s 12 community hospitals and 200 of its own locations, ensuring people throughout the region have access to advanced, specialized care close to home.
WashU Medicine is a global leader in academic medicine, including biomedical research, patient care, and educational programs. With more than 3,800 clinical providers, WashU Medicine delivers exceptional, research-driven care to the St. Louis region and to patients who travel from across the Midwest and the U.S. seeking the highest level of medical expertise. Practicing 101 specialties and offering access to more than 2,500 clinical trials, WashU Medicine provides answers, options, and hope to those who have run out of options elsewhere. Its 2,550 faculty physicians—many of whom are leaders in their fields—are the medical staff at BJC HealthCare’s nationally ranked Barnes-Jewish and St. Louis Children’s hospitals, and Siteman Cancer Center, the only National Cancer Institutedesignated comprehensive cancer center
Curiosus is published biannually by Barnes-Jewish Hospital.
2 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
Barnes-Jewish Hospital, WashU Medicine, and St. Louis Children’s Hospital are nonprofit organizations and do not endorse commercial products or services.
Executive editor Clinton Schulte, BJC HealthCare Copy editor Anne Makeever, Werremeyer Creative Featured contributing writers Cheryl Alkon, Shawn Ballard, Tim Fox, Darcy Lewis, Pam McGrath, Mark Reynolds, Kristina Sauerwein, Stephanie Stemmler, Julia Evangelou Strait, Marta Wegorzewska Design Werremeyer Creative
Subscribe Use the QR code on page 45 to subscribe to Curiosus, or visit BarnesJewish.org/Curiosus. Unsubscribe Send an email to: Clinton.Schulte@bjc.org
Up Front | Making Connections
Let’s Collaborate For Referring Physicians
Refer a Pediatric Patient
This issue of Curiosus was designed with For pediatric outpatient referrals and you in mind. We hope you find the stories inpatient transfers to St. Louis Children’s inside engaging and insightful. Hospital: call 800-678-4357. Should you be interested in referring a patient please use the contact information noted below.
Refer an Adult Patient Referrals and Physician Resources
Call: 314-747-3251 or (toll-free) 800-252-3627. Assistance is available 24 hours a day, seven days a week. BJC HealthCare Transfer Center: Call 314-362-0784 Referral Fax Form
Use this QR code to access a referral form. Printable PDF
Use this QR code. If you are sending patient information via email, please make sure to secure/encrypt that information. You may also fax this information securely to: 314-273-0440 or 314-273-0438. To obtain a free copy of our Guide to Clinical Services that includes our physician listings, office locations, and appointment phone numbers, email: wu.physicians@wustl.edu.
Assistance is available 24 hours a day, seven days a week. To request a directory of outpatient clinical services at St. Louis Children’s Hospital, email: ChildrensDirect@bjc.org.
Online Resources Our medical campus, which includes Barnes-Jewish Hospital, Siteman Cancer Center, St. Louis Children’s Hospital, and WashU Medicine, offers a number of resources for news and education. Continuing Medical Education
Use this QR code to access the Continuing Medical Education program. The CME International Referrals Office website is the central destination Call: 314-273-3780 for continuing medical education opportunities offered by WashU Fax: 314-362-1199 Medicine. Providers can explore upcoming Email: InternationalPatients@wustl.edu accredited courses, conferences, grand Use this QR code or visit rounds, and other activities designed to Physicians.Washu.Edu/ support lifelong learning and professional International for more development. information Medical Professional Education Center
Stay Informed WashU Medicine News Portal
Use this QR code to reach the news portal. Use this QR code to subscribe to Curiosus, or visit: BarnesJewish.org/ Curiosus
Our MPEC site features expert-led lectures, clinical videos, news, articles, publications, and specialty-specific content designed to support continuing education, enhance patient care, and keep health care professionals informed about advances in medicine across a wide range of specialties. Use this QR code to access the Medical Professional Education Center.
BarnesJewish.org/Curiosus | vol. XV, 2026 3
bench
WashU Medicine breakthroughs from the lab
Image courtesy of Shutterstock
4 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
CHEMICAL COMPOUND CLEARS CELLULAR WASTE, PROTECTS NEURONS IN MODEL OF FRONTOTEMPORAL DEMENTIA New research from WashU Medicine adds to growing evidence that helping brain cells break down and eliminate their own cellular waste is a promising treatment strategy for a variety of neurodegenerative diseases. In lab experiments, the researchers found that exposure to a novel compound developed at WashU Medicine can clear a harmful protein from human neurons modeling frontotemporal dementia—a devastating and ultimately fatal condition—and prevent those neurons from dying. The study was published March 31 in the journal Nature Communications. —Julia Evangelou Strait Image by Farzané Mirfakhar, WashU Medicine
Researchers at WashU Medicine have shown that a novel compound they developed can clear a harmful protein from human neurons modeling frontotemporal dementia (shown)
Read the full story
and prevent those neurons from dying.
INNOVATIVE CAR-T CELL THERAPY RECEIVES FDA BREAKTHROUGH THERAPY DESIGNATION A cell-based immunotherapy designed to treat rare and aggressive types of blood cancer has been granted Breakthrough Therapy designation by the U.S. Food and Drug Administration (FDA). This innovative CAR-T cell therapy is licensed to Wugen, a WashU Medicine startup biotechnology company based in St. Louis’ Cortex Innovation District. The immunotherapy was developed by WashU Medicine physician-scientists who treat patients at Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine. —Julia Evangelou Strait Photo by Alise O’Brien Photography
An innovative cell-based immunotherapy developed by WashU Medicine researchers has received Breakthrough Therapy designation from the FDA. The novel CAR-T cell therapy is licensed to
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Wugen, a WashU Medicine startup based in the Cortex Innovation District in St. Louis.
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up front | bench: WashU Medicine breakthroughs from the lab
NEW COMPOUND STOPS COMMON COMPLICATIONS AFTER INTESTINAL SURGERY Researchers at WashU Medicine have synthesized and tested a new compound in mice that shows promise in protecting the liver from damage and improving nutrient absorption after small bowel resection. They also found that the drug works only on the gastrointestinal tract, helping to avoid side effects in other parts of the body. The study was published March 6 in Gastroenterology. — Marta Wegorzewska
Image by Ayoung Kim, Daniel Lee, Bernd Zinselmeyer; WashU Medicine
After surgery to remove part of the small intestine in a mouse, normal liver tissue (red) is replaced by scar tissue (yellow-orange), which impairs the organ’s ability to function. The cyan color shows
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smooth muscle actin, a protein that indicates liver cells’ response to damage. Researchers at WashU Medicine made and tested a compound that protects the liver from this complication.
STUDY EXPLAINS HOW KETOGENIC DIETS PREVENT SEIZURES Researchers at WashU Medicine have shown in mice that a ketogenic diet causes physical changes in brain cells, affecting how they send information to one another and dampening the strength of the signals between them. This quieter neural landscape might explain how the diet calms the overactive electrical signaling that characterizes an epileptic seizure. The study appears in Cell Reports. — Mark Reynolds
Image by Sara Moser, WashU Medicine
Ketogenic diets, which are high in fat and very low in carbohydrates, have long been known to reduce epileptic seizures in some patients, but it hasn’t been clear why. A new study by WashU Medicine researchers shows in mice that the diet causes changes in the brain that dampen signaling between cells, opening a potential pathway to targeted therapies.
6 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
Read the full story
SURPRISING CULPRIT LEADS TO CHRONIC REJECTION OF TRANSPLANTED LUNGS, HEARTS A study led by researchers at WashU Medicine shows that chronic organ rejection may be triggered by the disruption of lymphatic vessels—an important drainage system throughout the body—from the donor organ rather than an attack by the patient’s immune system. The study was published Feb. 25 in Science Translational Medicine. It includes analyses of transplanted human organs with chronic rejection and mouse models of lung and heart transplantation. — Julia Evangelou Strait Image by Hailey Shepherd, WashU Medicine
A lung transplanted between genetically identical mice is laden with scar tissue full of hyaluronan (top half of image). Following a treatment to promote growth of lymphatic vessels, hyaluronan
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accumulation is markedly reduced (bottom).
A RISK FACTOR FOR LIVER DISEASE: YOUR PARENT’S BODY WEIGHT A new study from researchers at WashU Medicine shows that a person’s risk of developing one of the most common chronic liver disorders is strongly correlated to the level of obesity of their parents. Analyzing data from a large birth cohort in the U.K., the researchers found an association between the body mass index (BMI) of the parents while the mother was pregnant and their child’s risk of developing a condition known as metabolic dysfunctionassociated steatotic liver disease (MASLD). The findings, published in Gut Feb. 24, suggest that it might be possible to reduce a child’s risk of developing liver disease before they are even born. — Mark Reynolds Image by Sara Moser, WashU Medicine
Researchers at WashU Medicine have found a strong correlation between a person’s risk of developing liver disease and obesity in the father or mother during the pregnancy. The findings
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indicate that the risk for this disease begins much earlier than previously understood.
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up front | bench: WashU Medicine breakthroughs from the lab
BLOOD TEST “CLOCKS” PREDICT WHEN ALZHEIMER’S SYMPTOMS WILL START Researchers at WashU Medicine have developed a method to predict when someone is likely to develop symptoms of Alzheimer’s disease using a single blood test. In a new study published Feb. 19 in Nature Medicine, the researchers demonstrated that their models predicted the onset of Alzheimer’s symptoms within a margin of three to four years. This could have implications both for clinical trials developing preventive Alzheimer’s treatments and for eventually identifying individuals likely to benefit from these treatments. — Shawn Ballard Image by Sara Moser, WashU Medicine
WashU Medicine researchers developed a model to estimate when Alzheimer’s disease symptoms will begin based on the accumulation of amyloid and tau proteins in the brain. These proteins build up
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predictably over time, like tree rings, providing scientists with a clock for Alzheimer’s symptoms.
ENGINEERED IMMUNE CELLS HELP REDUCE TOXIC PROTEINS IN THE BRAIN
Image courtesy of Shutterstock
Chimeric antigen receptor (CAR)-T cell therapy, a type of immunotherapy that leverages the immune system to combat diseases, is a powerful treatment option for certain cancers. The treatment relies on genetically modified T cells to destroy cancer cells. Now, researchers at WashU Medicine in St. Louis and the Weizmann Institute of Science (WIS) in Israel and their collaborators have applied a similar approach to treating neurodegeneration. They engineered CAR-T cells to target plaques of a key Alzheimer’s disease-causing protein in the brain called amyloid beta. — Marta Wegorzewska
Researchers at WashU Medicine and Weizmann Institute of Science designed a cellular immunotherapy that reduced amyloid beta plaques in the brains of mice.
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Read the full story
bedside
breakthroughs in patient care
Photo by Gregg Goldman
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up front | bedside: breakthroughs in patient care
ADVANCED SCANNING TECHNOLOGY ENHANCES MEDICAL DECISION-MAKING WashU Medicine surgeons and physicians at Barnes-Jewish Hospital, St. Louis Children’s Hospital, and Siteman Cancer Center have access to some of the most advanced scanning technology available. As a result, physicians have access to tools that enhance diagnostic processes and improve patient care and outcomes. Vincent Mellnick, MD, WashU Medicine radiologist at Barnes-Jewish Hospital, says, “Thanks to the precision and speed of these advances, we can provide care that is faster, safer, and less stressful for the patients we treat.”
The expansive fleet of scanning options available includes iMRI, hybrid technology that combines angiography and CT scanning in a single device, and photon-counting scanners. All scans produced by these devices are read by an internationally renowned team of radiologists working at the WashU Medicine Mallinckrodt Institute of Radiology. Mallinckrodt experts represent a wide range of subspecialties, including abdominal, breast, cardiothoracic, neuroradiology, musculoskeletal, and pediatric imaging, among others. The team’s collective expertise in using these new technologies directly impacts treatment decisions and patient outcomes. iMRI technology
Barnes-Jewish Hospital was one of the first hospitals in the U.S. to install a multi-room system known as iMRI (intraoperative magnetic resonance imaging). The system provides immediate, diagnostic-strength (1.5 teslas), MRI visualization of the brain during surgery. It produces a detailed view of tumors and tumor margins during resections, and enhanced visualization of seizureproducing and healthy brain tissue during epilepsy surgery. Additionally, iMRI uses an integrated audio-visual and information management system,
meaning surgeons can compare intraoperative scans to previous scans and record in real time. They can also consult with other experts via videoconference during procedures. Eric Leuthardt, MD, WashU Medicine neurosurgeon at Barnes-Jewish Hospital, says, “The iMRI system gives us two important capabilities. First, we can evaluate the full extent of brain tumor resections, which provides greater precision and certainty that we are accomplishing the best treatment possible for patients.” The second capability, Dr. Leuthardt notes, is that iMRI can be transformative in enabling laser-based surgery. He says, “We can implant a robotically controlled laser probe into a tumor and watch MRI thermal imaging in real time as we ablate and kill tumor cells. Since treatment is performed through a small incision, it results in a radically less invasive surgery.” Minimally invasive laser surgery allows for treatment of what were previously considered inoperable tumors, including glioblastomas unsuitable for open surgery and metastases following radiation.
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Advanced neuroimaging technology provides
Eric Leuthardt, MD, WashU Medicine neurosurgeon
detailed visualization of brain structures that
Photos courtesy of WashU Medicine
support diagnosis and image-guided treatment. Combining angiography and CT
A new hybrid technology combines angiography and CT scanning in a single device. This innovation, the first available to patients in the region, allows for real-time imaging that enhances precision during image-guided interventions, including surgery. Using a process called “instant fusion,” this device can overlay CT scans onto real-time fluoroscopy images. As a result, scan time and radiation exposure are reduced. Another feature of the device, called “quick switch,” makes it possible for the patient to be moved between angiography and CT modes in just a few seconds, a process that streamlines treatment, including tumor ablation, among others. “When we use this device to care for a patient with cancer,” Dr. Mellnick says, “an interventional radiologist can use precision scanning to determine, immediately after injection of radioactive microspheres, that treatment was adequately delivered to the intended area.” He also notes that, because the device is housed in a single room, it can enhance the speed and accuracy of treating patients with trauma who cannot be easily moved from room to room.
Photon-counting CT
A photon-counting CT scanner uses technology that converts individual X-ray photons into electrical signals. This process precisely measures each photon’s energy, thus producing a highly detailed result. Traditional CT scanners can achieve this kind of precision only by taking multiple scans. With photon-counting CT, the need for fewer scans can reduce a patient’s radiation dosage by one-third. Other benefits include faster scan speeds and the potential to reduce the use of contrast media. Additionally, photon-counting CT scanners can be used in a wide range of clinical settings. Dr. Mellnick describes this technology as a practice-changing innovation. “Its precision enables us to derive more information from CT data. We can process the scans in ways that generate images closer to the precision of CT angiograms, for instance,” Dr. Mellnick explains. And, Dr. Mellnick notes, because BJC HealthCare has the largest U.S. fleet of these devices—with several housed at Barnes-Jewish Hospital’s new Plaza West Tower— “that capacity has increased our ability to schedule patients for CT scans in a timely and convenient manner, in particular for our inpatient population.” — PAM McGRATH
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up front | bedside: breakthroughs in patient care
LASER CORPUS CALLOSOTOMY FOR MEDICALLY REFRACTORY EPILEPSY Children with epilepsy who experience atonic seizures often wear helmets and other protective equipment to guard against injuries from sudden seizures that literally drop them to the ground. Jarod Roland, MD, WashU Medicine pediatric neurosurgeon at St. Louis Children’s Hospital, compares the rapid onset of these seizures to turning off a light switch. “There is an almost immediate loss of muscle tone throughout their body, and the falls they experience can cause facial injuries, chipped teeth, broken bones, skull fractures, and subdural hematomas,” Dr. Roland says. For some patients, atonic seizures can be controlled with antiseizure medications. But approximately 20% of patients are diagnosed with medically refractory epilepsy after at least two appropriately chosen medications prove ineffective. In those cases, other non-pharmacological options are explored. “A change of diet can be effective for a percentage of patients. Others may benefit from resective surgery of, for example, a lesion on the right lobe,” Dr. Roland notes. Neuromodulation devices, including vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS), can help, he adds. “But some patients with medically refractory epilepsy gain the greatest benefit from undergoing corpus callosotomy.” In open corpus callosotomy, a neurosurgeon performs a craniotomy to access and sever the nerve fibers of the corpus callosum that connect the brain’s hemispheres. The goal of this palliative approach is to eliminate atonic seizures and reduce the frequency and severity of all other seizures broadly, rather than specifically target the focal cause of the seizures. St. Louis Children’s Hospital, ranked 9th best children’s hospital in the country by US News and World Report for Neurology and Neurosurgery is the only pediatric hospital in the region to offer open callosotomy and a less invasive corpus callosotomy procedure, MRI-guided laser interstitial thermal
therapy (LITT). Dr. Roland and WashU Medicine pediatric neurosurgeon Sean McEvoy, MD, were both trained by a pioneer of the procedure, who performed the first LITT at St. Louis Children’s in 2017. Since then, 29 LITT corpus callosotomies have been performed at Children’s, a number that is virtually half of the total number of procedures performed to date in the U.S. Dr. Roland participated in a study of LITT, published in Epilepsia in 2023, that identified the many benefits of the less invasive procedure. He says: “Our analysis of open versus laser corpus callosotomies shows that patients undergoing the laser procedure experience less pain due to the small incisions, have hospital stays averaging three days compared to five, and recover faster. More importantly, the reduction in drop seizures was comparable to that achieved with an open surgery.” Patients range in age from infants through children in their teens. The decision as to which procedure is the best for each patient is determined by age, individual anatomical structure, and a multidisciplinary review. “Both the open and LITT corpus callosotomies are effective, well-tolerated procedures, especially in children, who generally recover from surgeries better than adults,” says Dr. Roland. “All surgeries have risks, but patients and their families have to weigh those against the risk of not having the surgery. For me, patients who have suffered severe injuries as a result of their atonic attacks have proven that the risks of not having surgery are far greater than the risks of the surgery itself.” — PAM McGRATH
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Both the open and LITT corpus callosotomies are effective, well-tolerated procedures, especially in children. — Jarod Roland, MD, WashU Medicine pediatric neurosurgeon at St. Louis Children’s Hospital
genu of the corpus callosum head of the caudate thalamus splenium of the corpus callosum
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A device transforms a patient’s white blood cells into a CAR-T cell therapy in Siteman Cancer Center’s Biologic Therapy Core Facility. This supports translational medicine efforts—from bench to bedside—in the fields of cellular therapy and gene therapy for treating blood cancers.
14 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
More Options for Blood Cancer Patients, Improving Survivability Siteman Cancer Center at Barnes-Jewish Hospital and WashU Medicine offers advanced therapies and clinical trials unavailable elsewhere, providing new paths forward. BY JULIA EVANGELOU STRAIT AND KRISTINA SAUERWEIN PHOTOGRAPHY BY MATT MILLER
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in focus | more options for blood cancer patients, improving survivability
The Blood Cancer Center at Siteman Cancer Center is recognized internationally as a leader in innovative care and draws patients from across the U.S. and overseas. The Center brings together the multidisciplinary expertise of WashU Medicine physicians who have a singular focus on treating blood cancers, including leukemia, lymphoma, multiple myeloma, and myelodysplastic syndromes. They have long been at the forefront of transforming care and pushing the boundaries of what’s possible in managing these complex cancers. Such progress stems from a solid foundation of research-informed care championed by internationally renowned leukemia expert John DiPersio, MD, PhD, WashU Medicine oncologist. Dr. DiPersio led WashU Medicine’s Division of Oncology for more than 25 years and was instrumental in establishing Siteman’s bone marrow
transplant program for patients with blood cancers as one of the world’s best. His ongoing research continues to move the field forward. In addition to developing novel cell-based immunotherapies, he is focused on alleviating graft-versus-host disease, a potentially deadly complication of bone marrow transplantation. His research has been fundamental to FDA approval of medications to mobilize stem cells for transplant and the first drug approved to treat graft-versus-host disease. WashU Medicine’s expertise in blood cancers runs deep. Physician-scientist Daniel Link, MD, also specializes in leukemia and conducts innovative research aimed at developing better treatments. He is deputy director of Siteman, as well as director of the WashU Medicine Division of Oncology. Dr. Link is a world leader in understanding hematopoiesis, the process by which different
Photo caption Danielle Albea, research lab supervisor (left) and Julie Ritchey, research lab manager for John DiPersio, MD, PhD, work in Siteman Cancer Center’s Biologic Therapy Core Facility to produce CAR-T cell therapy, a type of cell-based immunotherapy for treating blood cancers.
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“The trial has introduced a new and exciting opportunity for treating patients who lacked options.” — Armin Ghobadi, MD, clinical director of the Center for Gene and Cellular Therapy at WashU Medicine and Siteman Cancer Center
types of blood cells are formed. He has helped develop WashU Medicine’s hematopoietic malignancy research program into one of the top such programs in the country. He also leads efforts aimed at boosting translational research and moving promising investigational treatments, developed at WashU Medicine, into clinical trials at Siteman and beyond. In addition to Dr. Link, The Blood Cancer Center at Siteman is led by Amanda Cashen, MD, associate chief of the Hematologic Malignancies Program, and Brad Kahl, MD, director of the Lymphoma Program. Both Drs. Cashen and Kahl are WashU Medicine medical oncologists at Siteman and Barnes-Jewish Hospital. In 2025, Siteman Cancer Center celebrated a significant milestone in its Cellular Therapy Program: the infusion of its 500th FDA-approved cellular therapy product. Notably, each of the commercial cellular therapy products available on Siteman’s formulary was first administered here as part of an investigational clinical protocol prior to U.S. Food and Drug Administration (FDA) approval, reflecting the program’s long-standing commitment to advancing cellular immunotherapy through research and innovation.
Cellular therapies, including chimeric antigen receptor (CAR)-T cell and T cell receptor (TCR)-T cell-based tumor infiltrating lymphocytes (TIL) products, represent a transformative approach to cancer care, harnessing the power of a patient’s immune system to target and destroy cancer cells. New lines of inquiry
Several WashU Medicine physicians and researchers recently cofounded a startup company now called Wugen, which is developing several lines of cellbased immunotherapies for various cancers. Wugen’s cofounders include Dr. DiPersio; WashU Medicine physician-scientist Todd Fehniger, MD, PhD, co-leader of Siteman’s Hematopoietic Development and Malignancy Program; Matthew Cooper, PhD, a former faculty member and Wugen’s chief scientific officer; and Melissa Berrien-Elliott, PhD, a former postdoctoral researcher in Dr. Fehniger’s lab. Recently, Wugen partially funded an international, multicenter trial evaluating an innovative cellular immunotherapy developed by Dr. DiPersio and WashU Medicine colleagues, including Geoffrey Uy, MD, co-leader of the Hematopoietic Development and Malignancy Program at Siteman; Michael Kramer, MD, PhD; and Armin Ghobadi, MD, clinical director of the Center for Gene and Cellular Therapy at WashU Medicine and Siteman.
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in focus | more options for blood cancer patients, improving survivability
The trial involves CAR-T cell therapy, a type of cellular immunotherapy that uses genetically modified T cells to attack cancer cells. This particular CAR-T cell therapy is unique in that it is genetically engineered to attack T-cell cancers rather than B-cell cancers, the typical target of CAR-T cell therapies.
Notably, each of the commercial cellular therapy products available on Siteman’s formulary was first administered at Siteman as part of an investigational clinical protocol prior to FDA approval, reflecting the program’s long-standing commitment to advancing cellular immunotherapy through research and innovation.
Some patients who have received the CAR-T cell therapy have gone into remission, Dr. Ghobadi says. “The trial has introduced a new and exciting opportunity for treating patients who lacked options.”
People with blood cancers who seek care at Siteman have access to the most advanced diagnostic techniques, the latest, most advanced treatments, including immunotherapies, and an array of clinical trials aimed at developing new, more effective treatment options. “Our patients benefit from decades of outstanding clinical care and research led by WashU Medicine physicians and researchers at Siteman,” Dr. Cashen says. “This level of expertise also helps us recruit the brightest talents in blood cancer research and train a new generation of physicians and physicianscientists dedicated to further improving outcomes for patients.” Patients receive expert care that is guided by the most advanced genetic tests available, including a test called ChromoSeq, which can be used for known or suspected hematologic neoplasms, including acute myeloid leukemia (AML) and
myelodysplastic syndrome (MDS). The ChromoSeq test was developed by WashU Medicine physicianscientists Eric Duncavage, Dave Spencer, and Molly Schroeder. It was the first of its kind to be approved for reimbursement by the Centers for Medicare & Medicaid Services.
The Blood Cancer Center at Siteman also has received a prestigious Specialized Program of Research Excellence (SPORE) grant in leukemia from the National Cancer Institute—one of only two leukemia SPOREs in the country. The award funds research to develop the next generation of blood cancer therapeutics. Stem cell transplants provide the possibility of a cure for some blood cell cancers and can only be performed at specialized centers. WashU Medicine physicians have performed more than 10,000 stem cell transplants at Siteman, making the cancer center one of the largest and most experienced bone marrow transplant programs in the country. “Very few institutions in the U.S. have the expertise and resources that WashU Medicine and BJC HealthCare bring together to care for patients at Siteman,” Dr. Cashen says. “For patients with blood cancers, we draw on our wealth of experience, so they receive the very best care possible from a team that is absolutely committed to their care and supports patients every step of the way.” This story is reprinted with permission from WashU Medicine’s Outlook magazine and has been updated.
18 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
Spotlight | WashU Medicine Research at Siteman Cancer Center The ECHELON-Phase 3 clinical trial led by Nancy Bartlett, MD, WashU Medicine medical oncologist and bone marrow transplant specialist at Siteman Cancer Center and Barnes-Jewish Hospital, found that the use of an antibody-drug conjugate brentuximab vedotin, when combined with either lenalidomide or rituximab, was not only safe but also demonstrated improved survival benefit in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Approximately 40% of patients diagnosed with DLBCL have relapsed or have refractory disease. An international phase 1/2 clinical trial led by Armin Ghobadi, MD, WashU Medicine medical oncologist and bone marrow transplant specialist at Siteman Cancer Center and Barnes-Jewish Hospital, evaluated the safety and efficacy of an innovative CAR-T cell immunotherapy specifically designed to attack cancerous T cells—a new type of immunotherapy that targets aggressive blood cancers. The clinical trial showed promising results alongside manageable side effects. WashU Medicine researchers at Siteman Cancer Center and Barnes-Jewish Hospital have received a grant from Blood Cancer United (formerly the Leukemia & Lymphoma Society) for a Specialized Center of Research (SCOR) grant to improve clinical outcomes for patients with lymphoma or leukemia who are unlikely to be cured with currently available treatments.
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in focus |
Moving Medicine Milestones Forward in Transplantation BY TIM FOX
After the world’s first successful transplant—a kidney transplanted in 1954—the ensuing years were dedicated to repeating that success while minimizing the body’s rejection of the transplanted organ. In recent years, transplant medicine has focused on improving and increasing organ utilization to save more lives. In 2026, that goal has been accomplished. Thousands of people receive new organs every year, a remarkable and lifesaving achievement. But challenges remain. According to OrganDonor.gov, there are currently more than 100,000 adults and children in the U.S. on an organ transplant wait list, and every minute another person is added. Clearly, there are not enough organs to meet the need. The most pressing challenge, then, is to devise new ways to make better use of the organs available. How can they be better preserved, making potentially unviable
organs viable? How can immunosuppressive medications make more matches possible? How can one organ be used to treat more than one patient? How can we improve the experience of being a living donor? The WashU Medicine and Barnes-Jewish Transplant Center established itself as a leader in its earliest days, developing expertise in transplant and sharing it with the world. Now the Center is working to resolve the most recent problem in transplant medicine—helping to ensure that those in need receive the organs they need to survive and thrive. One example of success in this arena is occurring at St. Louis Children’s Hospital with its work using an innovative domino transplant procedure that uses a single donor organ to benefit multiple patients. The timeline presented here emphasizes the leadership, expertise, and innovation that has given the Transplant Center its reputation, while also establishing a way forward to meet future challenges.
20 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
1960-1990 1963
WashU Medicine surgeon William Newton, MD, performs the Midwest’s first kidney transplant at what was then Barnes Hospital. 1965
1985
A WashU Medicine team performs the first liver transplant at Barnes Hospital, launching its liver transplant program. At the time, it is one of nine such programs in the U.S. and one of 16 worldwide.
A WashU Medicine surgical team performs the region’s first living-donor kidney transplant at Barnes Hospital. 1973
WashU Medicine surgeon Charles Anderson, MD, establishes a kidney transplant program at Barnes Hospital. The transplant team begins hosting other U.S. and international teams to share their knowledge. A team of 20 surgeons and medical professionals performed the hospital’s first liver transplant on Aug. 21, 1985. Image courtesy of Bernard Becker Medical Library, WashU Medicine
WashU Medicine surgeon Morton “Ralph” Bollman III, MD, performs the first heart transplant at Barnes Hospital, launching its heart transplant program. Bollman’s immunosuppression protocol becomes the standard of care in heart transplantation. 1986
WashU Medicine pediatric cardiologist Charles Canter, MD, establishes the pediatric heart transplant program at St. Louis Children’s Hospital. The program serves patients—from newborns to those in their early 20s—with end-stage acquired or critical congenital heart disease. Charles Anderson, MD, visits with Dorothy Dobbs after her kidney transplant, circa 1973. Image courtesy of Bernard Becker Medical Library, WashU Medicine
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in focus | moving medicine forward
1990-2019 2009
1990
WashU Medicine surgeons perform the world’s first laparoscopic nephrectomy at Barnes Hospital, an innovation that results in improved recovery for patients. 1992
WashU Medicine cardiothoracic surgeon Alexander Patterson, MD, and former WashU Medicine cardiovascular surgeon Joel Cooper, MD, develop a new procedure, bilateral lung transplantation, that becomes a gold standard. The procedure provides transplant options for patients with cystic fibrosis.
Dr. Chapman and WashU Medicine hepatologist Jeffrey Crippin, MD, establish the WashU Medicine and Barnes-Jewish Transplant Center, bringing all solid-organ transplants—heart, lung, kidney, liver, and pancreas—into a single center. The Center becomes a national leader in establishing policy for donor-organ allocation and use. 2014
WashU Medicine specialist Tarek Alhamad, MD, MS, medical director of transplant nephrology, publishes the results of a study showing that curing hepatitis C increases the number of viable kidneys available for transplant.
1996 2016
The liver transplant team, including transplant surgeons, nurses, and other specialists, uses a living-donor liver for transplantation into an unrelated patient. This procedure is also the first adult-to-adult liver transplant procedure performed at Barnes-Jewish Hospital.
WashU Medicine becomes a leading U.S. center in a clinical trial to evaluate the effectiveness of normothermic machine perfusion (NMP) for liver preservation and transplant. 2019
2005
William Chapman, MD, WashU Medicine transplant surgeon at Barnes-Jewish Hospital, begins treating cholangiocarcinoma with liver transplantation. The team soon becomes a world leader in using transplantation to treat this disease.
The Transplant Center team performs its 10,000th organ transplant. The recipient received a kidney from a living donor identified through the hospital’s pairedexchange program.
William Chapman, MD, (right) performs liver transplant surgery. Photo courtesy of Barnes-Jewish Hospital
22 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
2020s 2024
2020
TRANSPLANTS
Dr. Chapman and the WashU Medicine team join one of 10 RESTORE trial sites testing NMP to convert donor livers that were unusable into transplantable organs. Early results show a 70% conversion. As a result, the Center emerges as a leader in using NMP to expand the number of available organs.
The St. Louis Children’s and WashU Medicine Heart Center becomes the first pediatric heart transplant program in the country to surpass 600 pediatric heart transplants. 2025
2023
WashU Medicine transplant surgeon Adeel Khan, MD, MPH, performs the first robotic-assisted liver transplant in the U.S. WashU Medicine surgeon Adeel Khan, MD, pictured here controlling a surgical robot, led the surgical team at Barnes-Jewish Hospital that performed the first robotic liver transplant in the U.S.
The St. Louis Children’s and WashU Medicine Heart Center performs the Midwest’s first domino partial heart transplant, in which one child receives a donated heart, and another child receives one or more valves from the heart removed from the transplant recipient.
Photo by Katie Gertler
Dr. Alhamad leads a study demonstrating that kidneys from COVID-19 positive patients are safe to transplant. Alhamad and fellow WashU Medicine researchers analyzed data from more than 35,000 kidney donors to arrive at their conclusion. At the beginning of the 2020 pandemic, deaths of those on kidney waiting lists increased by 43% as kidneys from COVID-positive patients were discarded rather than risk spreading the disease to organ recipients. WashU Medicine surgeon Daniel Kreisel, MD, PhD, leads an NMP clinical trial at Mid-America Transplant Services to evaluate the efficacy of restoring less-thanoptimal donor lungs for transplant. Thoracic surgeons Daniel Kreisel, MD, PhD, (left) and Varun Puri, MD, perform a procedure at Mid-America Transplant to recondition lungs prior to transplantation. Image courtesy of Mid-America Transplant
A collaborative team of experts from WashU Medicine and St. Louis Children’s Hospital, some of whom are pictured here, performed the first pediatric domino partial heart transplant in the Midwest. Image courtesy of WashU Medicine
The Transplant Center performs its first “beating heart” transplant, a method that keeps a donor heart beating until the moment of transplant. This innovation increases the distances donor hearts can travel, thus increasing the number of organs available to those on the wait list. 2026
Dr. Adeel Khan and the surgical team at Barnes-Jewish Hospital perform a robotic-assisted liver-kidney transplant, the first in the U.S. BarnesJewish.org/Curiosus | vol. XV, 2026 23
Leadership at the Fetal Care Center includes: (at left) WashU Medicine neonatal and perinatal pediatric physician Jagruti Anadkat, MD, co-director, and (at right) WashU Medicine maternal-fetal medicine physician and surgeon Katherine Bligard, MD, MA, associate director.
24 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
in focus | Q & A
The Fetal Care Center: A Model of Innovation Through Collaboration BY STEPHANIE STEMMLER PHOTOGRAPHY BY GREGG GOLDMAN
The Fetal Care Center, a partnership among Barnes-Jewish Hospital, St. Louis Children’s Hospital, and WashU Medicine, is a prime example of the way a commitment to collaboration can enhance patient care, promote innovation through research, and serve as a beacon of leadership in the field of fetal care medicine. In fact, some of the most advanced examples of care, including treatment for twin-to-twin transfusion syndrome and fetoscopic surgery myelomeningocele repair, to name just two, are available at the Center. The Center includes a multidisciplinary team of specialists who work together to care for mothers and babies on a single campus. In addition to providing expertise in diagnosis, imaging, and fetal and neonatal surgeries, the Center gives patients access to clinical trials. When facing complex or rare maternal and fetal diagnoses, patients and their families benefit from a comprehensive team that includes maternal-fetal medicine specialists, neonatologists, and fetal surgeons. Depending on the diagnosis, care is integrated with pediatric subspecialists, including cardiologists, neurosurgeons, nephrologists, geneticists, and neurologists, all working alongside dedicated nurse coordinators, bedside nurses, and social workers.
The Fetal Care Center is led by a multidisciplinary team of WashU Medicine specialists with national expertise in fetal, maternal-fetal, and neonatal care, including leaders in fetal surgery, advanced imaging, and high-risk obstetrics. The Center’s leadership team includes neonatal and perinatal pediatric physician Jagruti Anadkat, MD, co-director; maternal-fetal medicine physician and surgeon Katherine Bligard, MD, MA, associate director; pediatric and fetal surgeon Jesse Vrecenak, MD, surgical director; and Jeffrey Dicke, MD, maternalfetal medicine physician, vice chair of imaging and interim-co-chair. We recently spoke with Drs. Bligard and Anadkat about the Fetal Care Center’s multidisciplinary approach to care and shared clinical decision-making.
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in focus | Q & A: innovation through collaboration
“ The value of collaborative, multidisciplinary expertise is immeasurable. The patients we see are facing many decisions that must be made about serious, complex medical challenges. — Jagruti Anadkat, MD, WashU Medicine neonatal and perinatal pediatric physician
” Q: What distinguishes the Fetal Care Center’s approach to care?
Q: How does real-time collaboration among multiple specialists guide patient-care decisions?
Dr. Anadkat: The beauty of our center is that most physicians, surgeons, and other health care providers seeing patients do so within the Fetal Care Center itself; they come to the patient rather than the other way around. Significantly, we have not only the physical footprint of a single location, we also have—thanks to the multiple specialties available to care teams—a combined expertise focused on identifying the best options for patients.
Dr. Bligard: The care team reviews all the clinical information and imaging available. Those of us on the team review each patient’s medical concerns or conditions through a wide, multidisciplinary lens. Because the process includes fetal surgeons, neonatologists, pediatric specialists, and maternalfetal medicine specialists, we can evaluate the health of the mom as we consider fetal intervention, as well as neonatal intervention after delivery. Before we move forward to treatment, multiple viewpoints are discussed. Only after consensus is reached and a cohesive plan developed are we ready to discuss that plan with our patients.
Dr. Bligard: We see about 500 patients annually, many of whom come to us through referrals for diagnosis and care of complex fetal conditions, including neurodevelopmental and renal complications, cardiac intervention, and other situations that may require in utero surgery or quick intervention after delivery. We employ a shared-leadership model that inherently brings together adult and pediatric specialists. To further ensure cross-specialty collaboration, we hold weekly, multidisciplinary meetings to discuss every patient we care for. We use these meetings to come to a consensus on the path forward for moms and babies.
Dr. Anadkat: The value of collaborative, multidisciplinary expertise is immeasurable. The patients we see are facing many decisions that must be made about serious, complex medical challenges. We want to make sure that we look at all options available, so patients achieve the best possible outcomes. It also means that throughout the care process, we are prepared to anticipate what lies ahead for the patient and ensure we have the resources available, from pregnancy to labor and delivery, to neonatal care.
26 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
The link between Barnes-Jewish Hospital and St. Louis Children’s Hospital means that the labor and delivery rooms and the NICU are just a few steps apart.
Q: Does shared decision-making among adult and pediatric specialists enable you to broaden the services you offer patients? Dr. Bligard: Absolutely. Some fetal care centers offer diagnosis and counseling, then refer families to various specialists, many of whom may work at different locations. We offer services—from initial diagnosis to fetal and neonatal interventions—at Barnes-Jewish and St. Louis Children’s hospitals, which are physically linked, adjacent hospitals located on a single medical campus. In fact, labor and delivery at Barnes-Jewish Hospital is linked to St. Louis Children’s Hospital, making the NICU just a few steps away. We can easily access additional subspecialty consults at any time should the need arise. We can address complications in utero as needed, or address them post-delivery. If we anticipate a complicated delivery—an infant needing surgery or respiratory support immediately after delivery, for example—we can ensure an operating room or an intensive care bed is prepared at St. Louis Children’s Hospital as we deliver the baby at Barnes-Jewish Hospital. This kind of care requires expertise, communication, collaboration, and flexibility. The Fetal Care Center embodies these, which is what allows us to keep expanding the treatment options for patients. The collaboration we practice at the Fetal Care Center fosters curiosity and encourages a determination to find new solutions. That mindset
helps feed our robust program of clinical trials, an advantage for patients with complex challenges. Q: Can you give an example of this rapid translation of research into clinical care practices? Dr. Bligard: Late last year, we treated a rare fetal condition called early pregnancy renal anhydramnios (EPRA). It’s caused by a congenital fetal anomaly in the kidneys and urinary tract, and results in renal failure and a lack of amniotic fluid surrounding the baby during development. The drop in amniotic fluid also puts the fetus at high risk for pulmonary hypoplasia and death because amniotic fluid is essential for normal lung development. WashU Medicine physician-scientists at our center were part of a multicenter clinical trial evaluating the benefits of repeated amnio-infusions throughout pregnancy to improve survival and lung development in babies diagnosed with EPRA. The latest results, published in the summer of 2026, demonstrated that the therapy did improve overall outcomes. Thanks to this trial and our involvement, we were able to offer this innovative new treatment to one of our patients. The patient was given weekly amnio-infusions and delivered her baby at 34 weeks at Barnes-Jewish Hospital. Her baby was then brought to the Level IV NICU at St. Louis Children’s Hospital with lung development near normal. In ongoing care, our focus now is on addressing renal failure with options including dialysis and kidney transplant.
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in focus | Q & A: innovation through collaboration
Among other advanced treatments, the Fetal Care Center offers fetoscopic myelomeningocele repair and expert follow-up care.
Q: Do you also have the opportunity to develop your own studies because of what you observe while caring for moms and babies? Dr. Anadkat: Yes, we often initiate various clinical studies because we have multiple specialists who identify opportunities to improve care and outcomes. For example, we are the only center in the region—and one of only a few in the Midwest— to offer both fetoscopic and postnatal surgery for myelomeningocele. A multicenter observational study led by a team at WashU Medicine studied the frequency of sleep disordered breathing (SDB) in babies undergoing myelomeningocele repair and how that related to the timing of surgery (before or after delivery) and then prematurity at birth. Study results, published in early 2026 in Pediatrics, encouraged routine SDB screening and treatment to optimize neurodevelopmental outcomes in these babies. As leaders in the field, we deliver the very best care today while also continually redefining best practices and advancing the field.
Q: What are some of the most common conditions treated at the Fetal Care Center? Dr. Bligard: The most common conditions we treat include spina bifida, twin-to-twin transfusion syndrome, congenital diaphragmatic hernia, hydrocephalus, omphaloceles, and congenital heart conditions, including tetralogy of Fallot, hypoplastic left heart syndrome, atrial and ventricular septal defects, coarctation of the aorta, and transposition of the great arteries (TGA), among others. We are the only center in the region and among only a few in the U.S. to offer multiple surgical interventions, including fetoscopic, open, and post-delivery options. Q: What is the referral process for the Center? Dr. Bligard: Because we are a true multidisciplinary team, all patients are first referred to the Center itself. Upon referral, a team reviews medical records and immediately works to schedule that patient for imaging and other tests to confirm a diagnosis. We often spend more than an hour with each patient at the first visit—and that visit typically includes multiple specialists.
28 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
In a highly specialized fetoscopic procedure, fetal surgeons operate in utero, treating complex conditions before a child is born.
After we have the information we need, the care team quickly convenes to discuss the diagnosis, identify next steps, and develop a consensus for a personalized care plan. Should the mother or expecting parents want to include other family members on their team, we schedule online meetings so that everyone involved can ask questions. We focus on reducing stress for the patient by providing the information they need to feel confident every decision we offer is guided by multiple experts. Q: That strategy must bring comfort to families, knowing that they are supported in multiple ways. Dr. Anadkat: From my point of view, a center like ours is a dream. We have created a place where physicians and surgeons from multiple subspecialties work together daily to enhance the care of patients. We strive to deliver a consistent message to patients about their care from the outset. I think that effort, which results in an agreed-upon treatment plan formed by a team of experts, in consultation with parents, gives our patients greater comfort.
Our approach also ensures that pregnancy, delivery, and neonatal care are seamless. Because neonatologists are involved in treatment planning from the beginning, we know what interventions may be needed immediately after birth. If surgery is recommended prior to delivery, our pediatric fetal surgeons have been part of the care team from the beginning and making plans, as are specialists in pediatric cardiology, nephrology, and neurology, as each case warrants. We know it’s hard for our patients to have to face a complex medical condition involving pregnancy and delivery. They want to feel confident every avenue is explored, every possible treatment option considered. Multidisciplinary collaboration has become common in certain fields of medicine— oncology, for example. It makes sense in a fetal-care setting, too, where patients require a diverse range of adult and pediatric interventions. The Fetal Care Center’s collaborative, multidisciplinary nature exists to ensure that our patients—parents and their babies—receive the most effective care available and achieve the best possible outcome.
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in depth | featured stories
Saving face: advanced facial reconstruction after trauma For Brea Mack, the saying “wrong place, wrong time” took on a whole new meaning in January 2024 as she was driving her car. Suddenly, the 31-year-old mother-to-be heard a loud sound, looked down, and saw blood everywhere. Shock set in so quickly that she didn’t realize she had just been shot in the face. BY DARCY LEWIS PHOTOGRAPHY BY GREGG GOLDMAN
30 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
This image reveals the extent of damage Brea Mack incurred after a gunshot wound to the face.
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in depth | saving face: advanced facial reconstruction after trauma
Her husband, who was in his own car and driving near her, quickly realized the urgency of the situation and took Brea to the Emergency Department at Memorial Hospital, part of BJC HealthCare, where she received stabilizing care. She was then transferred to BarnesJewish Hospital. Not only did his quick actions help save her life, but arriving at the right hospital at the right time set in motion a multidisciplinary, coordinated response by WashU Medicine physicians and surgeons, and a team of dental specialists, nurses, technicians, and other clinicians, to rebuild Brea’s face. Now, more than two years later, she feels the team has truly brought her back to life. The level of coordinated care that Brea Mack experienced was very much by design, explains Rachel Anolik, MD, former WashU Medicine plastic and reconstructive surgeon at Barnes-Jewish Hospital and a member of a multidisciplinary facial-reconstruction team with deep expertise. “We’re usually alerted about a new facial trauma case before the patient even arrives at the trauma bay,” she says. “We often go to the OR with the acute care surgeons. They perform lifesaving stabilization surgery, while we do the initial soft-tissue cleanup and stabilization, to set the wound up for proper healing.”
WashU Medicine physicians at Barnes-Jewish Hospital have long provided exceptional care to patients with facial trauma and deformities. The maxillofacial reconstruction program is a subspecialty within the WashU Medicine Division of Plastic and Reconstructive Surgery, a team that treats patients needing nerve surgery—including nerve regeneration—hand surgery, and pediatric plastic surgery, among other areas of treatment. Patients from across the U.S. are referred to this WashU Medicine team at Barnes-Jewish Hospital. Dr. Anolik notes that Brea’s successful outcome is due to innovations the facial reconstruction team has introduced in recent years. “We’ve made significant progress in facial aesthetics, while also ensuring patients can perform basic functions and retain the ability to interact with people without feeling self-conscious,” she says. The team responsible for moving this field of medicine forward includes, among others, Azadeh Afshari, DDS, maxillofacial prosthodontist at BarnesJewish Hospital and St. Louis Children’s Hospital, and Zachariah Cole, DMD, MD, oral surgeon.
Azadeh Afshari, DDS, (left), maxillofacial prosthodontist at Barnes-Jewish Hospital and St. Louis Children’s Hospital, and Rachel Anolik, MD, (right), former WashU Medicine plastic and reconstructive surgeon at Barnes-Jewish Hospital
32 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
Prior to reconstruction, surgeons use virtual planning (shown at left) to maximize usage of the patient’s fibula. Image courtesy of WashU Medicine
Dr. Afshari finds that close collaboration among specialties is a critical component of bringing complicated facial reconstruction cases to a successful outcome. “One of the many benefits of this academic center is the communication we use to ensure patients are well cared for,” she says. “I like to say we see the end before we begin, because we work together to envision the finished result and agree on what we can achieve. We’re aligned while also respecting each other’s areas of expertise. The goal is to work together to make sure our patients receive the best care.” A blueprint for facial reconstruction
Not surprisingly, the process for reconstructing patients with devastating facial trauma or deformities involves multiple surgeries. The details vary, of course, but the following represents a typical treatment plan:
Initial stabilization and wound cleaning Once the patient has received lifesaving care, facial reconstruction surgeons explore the surgical site. The focus at this stage is removing bullet fragments or other foreign matter and bone shards, and debriding any soft tissue that has become necrotic. Patients often have oxygen support and a feeding tube at this point, says Dr. Anolik: “It’s a frightening time for them. The initial stages are all about survival and getting them through the trauma. But as they start to heal, patients become more concerned about quality of life and whether they will look ‘normal’ again.”
Virtual surgical planning and bone reconstruction The team uses virtual surgical-planning technologies to plan and optimize reconstruction. The actual procedure includes the harvesting of the patient’s fibula to create a new maxilla or mandible. The team overlays CT scans of the patient’s face and leg using a computer model that lets them use the undamaged side of the face to create a mirror image to guide the reconstruction. They also plan and orient the osteotomy cuts carefully to maximize the utility they can get from the patient’s fibula. “Dr. Anolik, Dr. Cole, and I coordinate our efforts to ensure we optimize the restorative work needed,” Dr. Afshari says. “Then, no matter how carefully we plan, things always change a bit in surgery, so small adjustments are always required as we go.” Once the team is satisfied with the patient’s new bony alignment, Dr. Anolik employs microsurgical techniques to ensure that both the blood vessels and nerves of the face and jaw will survive. She also grafts skin from the patient’s leg to substitute for native oral mucosal tissue. Dr. Afshari then designs custom plates to replace the missing bone. “The fibula has enough width and depth for reconstruction and for holding dental implants,” she says. “But just because you replace the bone doesn’t mean that it’s the correct height and in the correct position to accommodate the new teeth.”
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in depth | saving face: advanced facial reconstruction after trauma
Left fibula
Vessels left into left neck A titanium substructure, shown here, was used to rebuild Brea Mack’s mandible. Image courtesy of WashU Medicine
Dr. Afshari creates a custom titanium or zirconia metal substructure to build up what’s left of the native mandible. She has a state-of-the-art in-house lab that creates prosthetics ranging from dental reconstruction materials to silicon ears and noses.
Placement of dental implants At Barnes-Jewish Hospital, all aspects of facial reconstruction can be completed on the same campus. When dental implants are required, that aspect of care is performed on-site as part of a coordinated care plan. Once the patient’s bone heals following the initial surgery, Dr. Cole determines the precise placement of each dental implant and adds the necessary infrastructure. “It’s impossible to overstate how important this stage is,” Dr. Anolik says. “Sometimes patients never make it to dental restoration because proper planning was not done. And that’s heartbreaking to have to explain to a patient.”
Above: A temporary set of acrylic dental implants Below: The permanent prosthodontic, shown here in Brea Mack, is made of titanium or zirconium. Photos courtesy of WashU Medicine
Prosthetic restoration Once the patient’s mouth has healed from implant surgery, Dr. Afshari works to “retrain” the skin grafts inside the mouth from a normal inflammatory cutaneous response at the implant sites to responses more like the mucosal tissue it replaces. Initially, the patient is fitted with a temporary set of acrylic dental implants. The subsequent final prosthodontics are typically made of titanium or zirconium, a metal that looks like ceramic, Dr. Afshari says. “When enough bone is left and the implants have taken well, our goal is to create permanent appliances that look and feel like the patient’s own teeth.”
34 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
Brea Mack, after facial reconstruction surgeries
Scar revisions and refinements Dr. Anolik notes that it’s common for facial reconstruction patients to need one or two additional surgeries over time. All told, the comprehensive reconstruction process can take from 12 to 18 months to complete.
Brea notes: “I felt as though the entire team was just as concerned about my unborn son as they were about me. I gave birth to him about five weeks after the accident, on Valentine’s Day.”
A complex case
For Brea Mack, care and reconstruction were further complicated by her pregnancy. Every stage of her treatment plan included strategies for protecting her and her fetus.
Many of the patients seen by the WashU Medicine facial reconstruction team at Barnes-Jewish Hospital are new trauma patients, sometimes arriving via ambulance, and sometimes via helicopter. But others come via Siteman Cancer Center as oncology patients. Malignancies of the head and neck can take a heavy toll on the structures of the face and head, says Dr. Afshari, who completed fellowship training in dental oncology and maxillofacial prosthetics at the M.D. Anderson Cancer Center in Houston.
“We tried to wait until she delivered her baby, but her palate had essentially avulsed off her maxilla,” Dr. Anolik says. “We ended up taking her for an additional surgery between the cleanup surgery and the major reconstruction. The hospital’s team of WashU Medicine obstetric physicians were in the OR with us, tracking the fetus using fetal monitors. I quickly did a palatoplasty, which is similar to what we normally do for children with cleft palates.”
Barnes-Jewish Hospital and WashU Medicine offer trauma patients in need of maxillofacial reconstruction a level of expertise and advanced technology—including a dedicated dental team and prosthodontics lab—available at only a few hospitals in the Midwest. “My life changed the day I was shot,” Brea says. “It changed again—for the better—thanks to the care I received from the people who treated me. I’m grateful for their compassion and expertise.”
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in depth | featured stories
A model heart used to plan a complex pediatric transplant at St. Louis Children’s Hospital
36 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
Heart Transplantation at St. Louis Children’s Hospital and WashU Medicine
national reputation, local impact BY CHERYL ALKON PHOTOGRAPHY BY GREGG GOLDMAN
About 500 pediatric heart transplants occur each year around the world, according to the Pediatric Heart Transplantation Society. Over the past 40 years, more than 600 of these procedures have been performed by WashU Medicine transplant surgeons at St. Louis Children’s Hospital.
Photo courtesy of Shutterstock
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in depth | pediatric heart transplantation
“ In 2025, the WashU Medicine and St. Louis Children’s Hospital heart transplant team performed the Midwest’s first pediatric domino transplant. — Pirooz Eghtesady, MD, WashU Medicine cardiothoracic surgeon
” The WashU Medicine and St. Louis Children’s Hospital heart transplant program was established in 1986 and now is led by Lakshmi Gokanapudy Hahn, MD, medical director of pediatric heart failure and transplant, and Jacob Miller, MD, surgical director of heart transplant. With an emphasis on multidisciplinary collaboration, the transplant team includes cardiologists, congenital heart surgeons, anesthesiologists, pharmacists, social workers, and psychologists. In addition to caring for common pediatric heart conditions, including congenital heart defects, rheumatic heart disease, and arrhythmias, the team applies its collective expertise to complex conditions requiring highly specialized care. These include pediatric heart transplantation, valve transplants and replacements; domino valve transplants and valve procedures; and heart-kidney transplant. The pediatric transplant team also performs heart-liver, heart-lung, and heart-kidney transplants, among other multi-organ transplantations.
Pediatric heart transplantation
According to the Scientific Registry of Transplant Recipients, of the 69 centers in the U.S. that perform at least one pediatric heart transplant annually, fewer than 13% exceed 15 such procedures in a year. St. Louis Children’s Hospital’s pediatric heart transplant team, in its most recent reporting year, performed 18 procedures and has surpassed 600 total since the program began. In short, the experienced pediatric transplant team offers hope to children and their families who are living with high-risk heart conditions. The transplant team collaborates across multiple disciplines to manage the complications of heart-transplant care before, during, and after surgery. It includes physicians who manage patients already on immunosuppressant medication due to a previous transplant, as well as those who are receiving ventricular support as they wait for a donated heart. Infants and children with heart conditions may undergo more than
38 CURIOSUS | Barnes-Jewish Hospital + WashU Medicine + St. Louis Children’s Hospital
one heart surgery, which complicates an already complex procedure. Pirooz Eghtesady, MD, PhD, WashU Medicine cardiothoracic surgeon and chief of pediatric cardiothoracic surgery at St. Louis Children’s Hospital, notes that, as a result of multiple surgeries, “scar tissue can adhere to the back of the patient’s chest, which can heighten the risk of damage during subsequent surgeries.” The team has, however, used heart transplantation to successfully treat even the most complex cases, including, Dr. Eghtesady says, “a patient who had 10 prior heart surgeries before we performed a heart transplant surgery.” Pediatric valve transplants and replacements
While adult valve transplants and replacements have been performed in the U.S. for more than 60 years, pediatric valve treatment options historically have been limited, in part because manufactured heart valves are made of materials that cannot grow along with the patient.
Pirooz Eghtesady, MD, PhD, (center) WashU Medicine cardiothoracic surgeon and chief of pediatric cardiothoracic surgery at St. Louis Children’s Hospital
“Bioprosthetic valves made of animal tissue, or mechanical valves made of metal, are usually sized for adults,” Dr. Eghtesady says. “We can use them for pediatric patients, but only those who are essentially the size of a small adult.” To treat younger, smaller children in need of a new heart valve, the WashU Medicine and St. Louis Children’s team has used a strategy called the Ross procedure, in which one of the patient’s own pulmonary valves is used to replace an aortic valve; a donor valve is then placed in the pulmonary position. Another option, partial heart transplant, uses a valve or valves from a donor heart. This procedure often is used to treat infants and children with irreparable valve defects because the donor valves can grow with the child.
Domino valve transplant
“In 2025,” Dr. Eghtesady says, “the WashU Medicine and St. Louis Children’s Hospital heart transplant team performed the Midwest’s first pediatric domino transplant.” At the time, this rare, lifesaving procedure had been performed at only seven other hospitals in the U.S. This option benefits two patients using a single donor heart. During the procedure, a donor heart is transplanted into a patient requiring a new heart. The healthy valves from this patient’s original heart are then made available for transplantation in another patient in need of a replacement valve or valves. “We call it a domino heart transplant,” Dr. Eghtesady says, “but it’s more accurate to say it is a domino valve
transplant. The procedure has been used to transplant one or two valves, though theoretically it could be used to replace four.” “This process requires extensive planning and precise coordination,” says Lakshmi Gokanapudy Hahn, MD, WashU Medicine pediatric cardiologist and medical director of the pediatric heart transplantation program at St. Louis Children’s Hospital. The team that performed this complex procedure included more than 20 specialists working in two operating rooms—and involved WashU Medicine pediatric heart transplant surgeons, cardiologists, cardiac intensivists, and anesthesiologists, as well as inpatient and operating room nurses, perfusionists, transplant coordinators, Child Life Specialists, and other practitioners at St. Louis Children’s.
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in depth | pediatric heart transplantation
Lakshmi Gokanapudy Hahn, MD, WashU Medicine pediatric cardiologist and medical director of pediatric heart transplant at St. Louis Children’s Hospital
“The complexities are myriad because the procedure involves two recipients, one donor heart, and valves supplied by the heart-transplant patient. It requires a very large team and many precise steps,” Dr. Gokanapudy Hahn says. One team travels to retrieve the donor organ, then returns to the hospital where the heart transplant will take place. A surgical team performs the heart-transplant procedure, and another team delivers the valves removed from the donor heart to an adjacent operating room, where a patient and surgery team are prepared for the valve transplant. “We plan the domino procedure down to the minute,” Dr. Gokanapudy Hahn says, “because every minute matters.”
The domino procedure represents a significant improvement in the field of pediatric heart transplantation. Through careful coordination, it makes use of the functioning valves in a heart removed during transplantation. “Instead of discarding an organ, we have the opportunity to use parts of it to help other patients,” says Dr. Gokanapudy Hahn. The procedure also adds to the body of knowledge informing immunosuppressant care in pediatric heart-transplant patients. While all immunosuppression strategies pose potential risks, Dr. Eghtesady notes, empiric data indicates that patients with pediatric valve replacement require less immunosuppression medication than those who undergo
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heart transplantation. Accordingly, valve-replacement patients typically receive standard immunosuppression treatment for the first six to 12 months after transplant surgery, then transition to lower levels of treatment to suppress organ rejection. To date, fewer than 50 pediatric domino valve procedures have been done in the U.S. WashU Medicine transplant surgeons at St. Louis Children’s Hospital continue to evaluate patients to determine their eligibility for the procedure. Pediatric heart-kidney transplant
In another advance, the heart transplant team performed Missouri’s first pediatric heart-kidney transplant in 2025. During this procedure,
Two Patients — One Heart Domino Valve Transplant
Deceased Donor Heart
Patient 1 Heart Transplant
Heart Removed From Patient 1
In OR1, the patient undergoes heart transplantation using a deceased donor heart.
Valves from the removed heart are recovered, prepared, and delivered to OR2.
Patient 2 Valve Transplant
In OR2, the second patient receives donor valve(s).
20+ specialists including surgeons, cardiologists, anesthesiologists, nurses, perfusionists, coordinators 2 operating rooms closely coordinated and working in tandem
In 2025, WashU Medicine and St. Louis Children's Hospital performed the Midwest's first pediatric domino valve transplant. At the time, it was the 8th pediatric surgery of its kind in the U.S. To date, fewer than 50 pediatric domino valve transplants have been performed in the country.
an adolescent received a second transplanted heart—the first donor heart was transplanted shortly after birth. When that heart began to fail and the kidneys stopped functioning, the patient required another lifesaving transplant—this time requiring two organs. When donor organs became available, the patient underwent heart transplantation first. Twenty-four hours later, the team performed kidney transplantation. Dr. Eghtesady notes that such procedures are uncommon, but the need for them may be caused by the potential damage long-term immunosuppression therapy can cause to the kidneys, potentially resulting in end-stage disease and reduced perfusion.
National reputation, local impact
The U.S. Food and Drug Administration (FDA) has named St. Louis Children’s Hospital a designated tissue processing center. To earn this designation, the hospital completed a rigorous process to demonstrate full compliance with FDA regulations regarding tissue retrieval, storage, labeling, and distribution. When evaluating a patient for heart transplantation or domino procedure, the team looks closely at a patient’s medical history and assesses the patient’s and family’s ability to consistently manage post-transplant care, including immunosuppression. These important factors in transplant success are more easily achieved when patients and families have access to a transplant center that
manages all aspects of care in one location. The WashU Medicine and St. Louis Children’s Hospital pediatric heart transplantation program gives patients and families in the region access to world-class, coordinated, and compassionate care. The transplant team’s innovations have kept it at the forefront of the field. But, as Dr. Gokanapudy Hahn notes, such innovations are rooted in the devastating loss, careful considerations, and altruistic choices of others. “As a transplant team, we’re aware that we can’t do what we do without donor families, whose generosity saves lives,” Dr. Gokanapudy Hahn says. “When a child dies, the parents are experiencing the worst day of their lives, and they are choosing to pass life on to another child. This is a tremendous gift.”
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in depth | featured stories
Congenital heart disease and the pediatric-to-adult care gap Fifty years ago, only about 25% of children born with congenital heart disease (CHD) survived beyond infancy. Today, more than 90% of babies with CHD survive to adulthood, according to the American College of Cardiology.
BY CHERYL ALKON PHOTOGRAPHY BY GREGG GOLDMAN
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in depth | congenital heart disease and the pediatric-to-adult care gap
This dramatic increase in survival is a direct testament to the power of modern medicine. Heart conditions that were once fatal are now often repaired in infancy or early childhood, long before the affected child can independently blow out a candle on a birthday cake. Today, there are more than 1.4 million adults with congenital heart disease (CHD) living in the United States—and approximately 40,000 babies born with CHD in the U.S. annually, according to the Centers for Disease Control and Prevention. These patients require lifelong, specialized cardiac care, including regular check-ups with a cardiologist, advanced imaging, and potential medication or surgical interventions to manage conditions including arrhythmias or heart failure. But while the vast majority of children with CHD in the United States receive specialty cardiac care, fewer than 30% of adults with CHD receive subspecialty care, according to a 2022 statement from the American Heart Association. Continuity of care
To date, approximately 2,000 adults and children with CHD have received support at St. Louis Children’s Hospital and Barnes-Jewish Hospital. Given the advances in treatment, these children are likely to transition to adult care in the future, many of them through the Center for Adults with Congenital Heart Disease at the WashU Medicine and Barnes-Jewish Heart & Vascular Center. “We provide the outreach and support needed to see these children successfully transition from a pediatric program to one for adults. We want to keep them from falling through the gaps,” says Ugonna Nwankwo, MD, WashU Medicine cardiologist and director of the Center for Adults with Congenital Heart Disease. “We’ve found that many adults with CHD were told as they were growing up, ‘You hit age 18; everything looks fine. You don’t need to see a specialist anymore,’” says Dr. Nwankwo, a quadruple board-certified physician in
pediatrics, internal medicine, pediatric cardiology, and adult congenital heart disease. Nwankwo and his team offer seamless care, from infancy through adulthood, to people with CHD. Because St. Louis Children’s Hospital and Barnes-Jewish Hospital occupy the same campus, care teams can offer patients efficient and effective support and treatment. “One of the biggest barriers to continuity of care is a lack of communication between the pediatric and adult worlds,” Dr. Nwankwo says. Making the transition from pediatric to adult care
When a child is born with congenital heart disease, a family member or guardian almost always becomes the primary decision maker for the infant. But as those children mature into adolescence and early adulthood, those who do not learn how to manage their health or navigate the health system are at a disadvantage—and at increased risk of falling away from care after they age out of pediatric cardiac programs. In 2011, the American Heart Association published a scientific statement establishing best practices for patients with CHD as they transition from pediatric to adult care. The guidance emphasizes the importance of beginning early (around ages 11–13, if possible) and gradually shifting responsibility from family caregivers to the patient. “What we’ve found over the years is that transitioning patients from the pediatric to adult care is invaluable. They receive continuous care while also learning how to assume responsibility for their health,” Dr. Nwankwo says. “When we teach patients about their heart disease and about the responsibilities and benefits of self-care when they reach adulthood, we give them the tools they need to succeed.” In St. Louis, St. Louis Children’s Hospital and Barnes-Jewish Hospital have developed a program called TEACH (Transition Education for Adolescents
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“ When we teach patients about their heart disease and about the responsibilities and benefits of self care when they reach adulthood, we give them the tools they need to succeed. — Ugonna Nwankwo, MD, WashU Medicine cardiologist
” Ugonna Nwankwo, MD, WashU Medicine cardiologist and director of the Center for Adults with Congenital Heart Disease.
with Congenital Heart disease), headed by Rebecca Hartog, MD, a WashU Medicine pediatric cardiologist at St. Louis Children’s Hospital and Barnes-Jewish Hospital, and Laura McGinty, MSN, a dual-certified pediatric acute care and nurse practitioner. Consistent with national best-practice guidance, the program begins working with patients in early adolescence and continues across multiple years, allowing education and responsibility to build gradually over time. The care team discusses the child’s diagnosis and treatment in developmentally appropriate language, involving both the child and family members. During the transition process from pediatric to adult care, appointments with the patient are designed to be both developmentally appropriate while also introducing complex medical concepts. When the patient reaches age 15 to 17, and is ready for more independence and
responsibility, the care team introduces newly relevant lifestyle topics, including self care. As the patient nears the end of adolescence, appointments focus on logistics. The medical team shares information with the adult congenital heart disease program and ensures that the teen is up to date on all recommended health maintenance. The team helps schedule appointments and makes sure the adolescent or young adult knows who to call for care. There is also a distinct emphasis on autonomy. “We really want them to understand, ‘You are the main advocate for your care,’” Dr. Nwankwo says. Youth officially transition to the adult congenital heart program at Barnes-Jewish Hospital and WashU Medicine when they are ready—usually between ages 18 and 22.
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in depth | congenital heart disease and the pediatric-to-adult care gap
Ugonna Nwankwo, MD, WashU Medicine cardiologist, reviews a cardiac scan.
Regional access matters
Despite the proven benefits of pediatric-to-adult programs and continued specialty care after age 18, most young adults with CHD do not receive regular medical care from a specialized medical team with expertise in congenital heart disease. Geography is a major contributing factor. According to a 2019 study published in Congenital Heart Disease, approximately half of the U.S. population lives more than one hour away from an adult congenital heart disease center. Similarly, transition programs for adolescents and young adults tend to be found in large urban areas, making access challenging for rural youth and families who lack reliable transportation or resources to travel. Easy access to comprehensive care
“We have one of the most robust cardiology teams, not just locally, but in the country,” Dr. Nwankwo says. “We have world-class congenital pediatric and adult cardiac surgeons. We have one of the highest volume heart transplant programs around, both for pediatric and adult heart transplants. In fact, St. Louis Children’s Hospital was the first hospital in the U.S. to exceed 600 pediatric heart transplant procedures.” Additionally, Barnes-Jewish Hospital holds Comprehensive Cardiac Center Certification from the Joint Commission.
At St. Louis Children’s Hospital, a dedicated thoracic aortic program is led by WashU Medicine surgeons John Ohman, MD, and Puja Kachroo, MD, codirectors, and WashU Medicine cardiologist Alan Braverman, MD, serving as director of the Marfan Syndrome and Aortopathy Center. “We have a very robust and busy electrophysiology service for people with electrical heart problems. Congenital patients who come here have access to it, all within one institution,” Dr. Nwankwo notes.” While early involvement in a pediatric-to-adult transition program is ideal for individuals with congenital heart disease, it’s never too late to connect a patient to care. Patients or family members can call 314-362-1291 directly for more information. Referring physicians are welcome to initiate contact. “I get referrals from across Missouri and Illinois, and outside of the bi-state area, including Arkansas,” Dr. Nwankwo says. “Doctors refer people here because they know we have a robust program.” For patients with congenital heart disease, access to specialized services is just part of the equation. Even more important is sustained engagement that supports them as they assume greater responsibility for their health over time. Dr. Nwankwo notes: “We want to help them grow progressively so they can manage their own care as the end result.”
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In This Issue WashU Medicine Breakthroughs From the Lab Advanced Scanning Technology Enhances Medical Decision-Making Laser Corpus Callosotomy for Medically Refractory Epilepsy More Options for Blood Cancer Patients, Improving Survivability Moving Medicine Forward: Milestones in Transplantation The Fetal Care Center: A Model of Innovation Through Collaboration Saving Face: Advanced Facial Reconstruction After Trauma Heart Transplantation at St. Louis Children’s Hospital and WashU Medicine: National Reputation, Local Impact Congenital Heart Disease and the Pediatric-to-Adult Care Gap
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