Figure 51-17 Indication for heart transplantation in children. Over the past two decades, the major indications for pediatric heart transplantation were nearly equally divided between congenital malformation and cardiomyopathy. In later years, pediatric recipients with congenital malformations assumed a slight plurality due to shifting age demographics. As illustrated, younger children are more likely to undergo heart transplant because of congenital malformation. (Data from the Registry of the International Society for Heart and Lung Transplantation.^[240] )