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Survival of Heart Transplant Candidates in Japan. BACKGROUND: In Japan, there are more patients waiting for heart transplants (HTXs) than available organs. Methods and Results: Since July 2010, 68 pediatric and 366 adult patients aged <60 years applied for HTX candidacy with the Japanese Circulation Society's HTX Committee. No significant differences in freedom from death or HTX were observed between pediatric Status 1 and Status 2 patients. More adult Status 1 patients reached the endpoint of death or HTX than adult Status 2 patients. Pediatric patients (Status 1 and 2) did not have better survival than adult Status 1 or Status 2 patients. CONCLUSIONS: Pediatric patients should be prioritized over adult patients for HTX.