Pediatric thoracic organ transplant recipients are an important and biologically unique component of the overall experience in thoracic organ transplantation. Issues of immunologic naivete, growth and development make the pediatric recipient an important biologic model to aid in our understanding of overall thoracic organ transplantation. This report documents stability in the number of pediatric recipients and notes the continued trend of markedly improved survival for heart recipients in the most recent years. Despite improved survival, the overall number of reported pediatric recipients has remained stable, underlining the rate-limiting step of donor organ availability. Compared with previous years, this report offers an expanded analysis of donor and recipient characteristics. Risk factor analysis for mortality is expanded to include parameters important for 5-year survival. A more thorough description of immunosuppressive medication usage and actuarial freedom from morbidity curves represent new analyses of the pediatric data. These data are intended to analyze our experience to date and also to highlight areas where our experience and knowledge base need expansion in the future. HEART TRANSPLANTION Transplant Volumes and Indications