Age is an important factor that has been demonstrated to affect patient survival, although there is evidence that its effect has declined in recent years. Several early reviews showed increased mortality in young children and, particularly, in those under 2 years of age at transplantation: in two studies there was a mortality rate of 21% [
5,
28]; however, more recently, survival rates of over 98% have been reported [
29,
30]. Increased risk of death was also seen to extend up to age 5 years at transplantation: Dutch data showed that the mortality rate was nearly twice as high in those under 5 years of age than in those 6 to 10 years old [
19]; in a review of children with an average age of 4.7 years who weighed <20 kg at transplantation, 19% were reported to have died [
23]. A reduction in mortality rate has occurred in this age range too, with a halving of the mortality rate between the 1970s and 1980s in the Dutch report [
19], a mortality rate of 8.2% unaffected by age less than or older than 5 years at transplantation [
1], a 5-year survival rate of over 97% in under 6 year olds [
31], a 91% 10-year survival rate in those weighing <15 kg [
25], and 87% 15-year survival in those <11 kg at transplantation [
32]. Most studies have small numbers of subjects, making statistics and interpretation difficult; however, what does seem to be the case is that deaths in those who had received transplants before they were 5 years old occur sooner after transplantation (indeed all the deaths in the younger age group were in those less than 15 years of age) than in those that had received transplants when they were over this age [
1].