Cardiac transplantation: a review.

Cardiac transplantation is currently a highly successful treatment for selected patients with end-stage cardiac failure. The long-term results are limited by the development of coronary artery vasculopathy, infection and malignancy. The activity of transplantation programmes worldwide is severely limited by the availability of donor organs. Further refinements of immunosuppressive agents are likely to result in improved prevention of both acute and chronic rejection. The donor pool is unlikely to be significantly extended as a result of measures to increase donor organ supply. Alternative methods to allograft transplantation need further investigation to increase the number of therapeutic options available for those patients with end-stage heart failure.