Evolution of heart transplantation.

Heart transplantation has evolved from preliminary animal experimentation in the early part of this century to an accepted orthodox therapy for many patients with end-stage cardiac disease in the 1980s. The development of successful heart transplantation is traced from the laboratory to early clinical attempts and the subsequent validation of this therapy, principally by the Stanford group in the 1970s. The dramatic worldwide impact of the use of cyclosporine for immunosuppression in the practice of heart transplantation is reviewed. Resultant changes in the practice of heart transplantation are discussed as well as the future developments of totally implantable circulatory support systems and xenografting.