Patients awaiting heart transplantation (HT) may become sensitized with human leukocyte antigen (HLA) antibodies. Sensitization reduces a HT candidate’s effective donor pool, promoting longer waitlist times and increasing risk of waitlist mortality. The efficacy of desensitization therapies, which aim to reduce anti-HLAs in sensitized patients, remains unclear. Pediatric HT candidates listed at CHOP between July 1, 2018 and June 30, 2024 were retrospectively evaluated. All HT candidates were categorized as non-sensitized (NS), sensitized not receiving therapy (SNT), or sensitized receiving therapy (ST). Measured outcomes include successful transplant, DSA production post-transplant, and incidence of either acute cellular rejection (ACR) or antibody-mediated rejection (AMR). For statistical analysis, chi-square and ANOVA were used to compare patient characteristics among groups both pre- and post-transplant. Patients in the ST group were more likely to have had homograft exposure and had a longer wait time to transplant. There was no significant difference in rate of rejection among groups, but more DSA was seen in the ST group. For the ST group, each patient was administered at least one (and up to five) desensitization therapies. Future study will evaluate the efficacy of the therapies and predictors of positive response to desensitization.