From december 84 to december 95, 42 cardiac transplantations (Tx) were performed for 39 patients (pts), 14 females and 25 males, aged 1 day to 21 yrs(mean 12,4 yrs, med. 14 yrs). Indications were cardiomyopathics (19 cases), congenital cardiopathies (20) and cardiac allograft dysfunction (3). Twenty-three pts could wait for Tx at home (54.8%), 19 could not be discharged(6 required extracorporeal circulatory assistance). Global mortality is 28.5%: 12 pts died, 1 day to 6,5 yrs after surgery; 8 deaths (66.7) occured during the 1st mth (6 before the 8th day, 1 at the 10th day, 1 at 1 month), 1 pt died at 2nd mth, and 3 after 1 yr follo-up (FU). Early mortality was caused by multivisceral failure (3 cases), infection (2), acute rejection (AR) (1), pulmonary hypertension (1) or extracardiac problem (2). Late deaths were caused by AR (2) and sepsis (1). Twenty-seven pts are allved and 2 are retransplanted. Global survival is 80.6% at 1 mth, 78% at 1 yr, 74% à 5 yrs. 61.2% at 10 yrs. FU is 4 mths to 11 yrs (mean 4,5 yrs, median 3,5 yrs); 23 pts survived more than 1 yr FU and 3 of them died (13%), survival of long term followed pts (FU>1 yr) is 87%. Immunosuppression is achieved by tritherapy. AR mainly occured during the first 3 mths (1 to 3/pt), less frequent in children. Allograft dysfunction appeared in 3 cases (1 proved coronaropathy). Renal function is normal in 55% of pts, ciclosporine induced renal dysfunction is moderate in 25% of pts, significant in 20%; linear growth ranges within normal values. No malignant proliferation occured. Psychological disturbs specifically concern adolescent population. Results of cardiac pediatric transplantation show optimal pts's survival and quality of life; but long term renal function in infants and allograft survival still remain uncertain.