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The cohort was split based on the era of transplantation (ERA I: 1989\u20132008, ERA II: 2009\u20132023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 254 children were listed and 185 (72.8%) reached pHTx, with no loss to follow\u2010up. Waiting list duration was 62\u2009days and increased over time, while mortality on the waiting list decreased (30.5% in ERA I, 8.8% in ERA II). Congenital heart disease was the etiology of heart failure in 36.2% of recipients, including 24.9% with univentricular physiology. The frequency of ABO\u2010incompatible transplantations was 9.3% and 8.0% were considered to be at high immunological risk pre\u2010pHTx due to pre\u2010formed HLA\u2010antibodies with mean fluorescence intensity \u2265\u20095000. Ventricular assist device (VAD) was used in 26.9% of recipients. Long\u2010term survival was not affected by age, heart failure etiology, the use of pre\u2010transplant VAD, or elevated baseline indexed pulmonary vascular resistance. Era of transplantation was a determinant of listing, but not post\u2010pHTx outcome. Survival at 1\u2010, 10\u2010, and 30\u2010year follow\u2010up was 94.5%, 79.4%, and 57.1%, respectively. Of the total\n                      <jats:italic>de novo<\/jats:italic>\n                      DSA burden, 45.9% were HLA\u2010DQ\u2010type specific. Re\u2010transplantation was performed in 5.9% of recipients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A high quality of care has been achieved in Sweden, despite modest pHTx numbers, in cooperation with the Scandiatransplant organization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70154","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T04:20:18Z","timestamp":1755490818000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comprehensive Analysis of the First 35\u2009Years of Pediatric Heart Transplantation in Sweden"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4726-0697","authenticated-orcid":false,"given":"Oscar","family":"van der Have","sequence":"first","affiliation":[{"name":"The Pediatric Heart Center Sk\u00e5ne University Hospital  Lund Sweden"},{"name":"The Department of Experimental Medical Science and the Wallenberg Center for Molecular Medicine Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4753-3811","authenticated-orcid":false,"given":"H\u00e5kan","family":"W\u00e5hlander","sequence":"additional","affiliation":[{"name":"The Pediatric Heart Center The Queen Silvia Children's Hospital, Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4848-1927","authenticated-orcid":false,"given":"Tove","family":"Hofbard","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Transfusion Medicine, Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4448-4594","authenticated-orcid":false,"given":"Dace","family":"Abele","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Clinical Immunology and Transfusion Medicine Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-5975","authenticated-orcid":false,"given":"Maria Sj\u00f6borg","family":"Alpman","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Astrid Lindgren Children's Hospital, Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Women's and Children's Health Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3571-1168","authenticated-orcid":false,"given":"Ilse Duus","family":"Weinreich","sequence":"additional","affiliation":[{"name":"Scandiatransplant, Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-8352","authenticated-orcid":false,"given":"Jens","family":"B\u00f6hmer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Pediatrics Clinic Frankfurt\u2010H\u00f6chst  Frankfurt Germany"},{"name":"Transplant Institute Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6860-6090","authenticated-orcid":false,"given":"Johan","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Thoracic Surgery and Bioinformatics Lund University  Lund Sweden"},{"name":"Department of Cardiothoracic and Vascular Surgery Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2202-6511","authenticated-orcid":false,"given":"Jan","family":"Holgersson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Clinical Immunology and Transfusion Medicine Sahlgrenska University Hospital  Gothenburg 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