Progress in cardiac transplantation.

This article summarizes general practices in cardiac transplantation, including the selection of recipients and pretransplant management, selection of donors, surgical technique, management of perioperative complications, and induction and maintenance protocols for immunosuppression. Advancements in the management of rejection and infection also are included. Coronary artery disease is the most frequent cause of late death in spite of improved immunosuppressive regimens, antiplatelet agents, and lipid-controlling drugs. Still, long-term survival has improved markedly. A brief description of the Texas Heart Institute experience with 532 cardiac transplants is provided.