Cardiac transplantation is now an accepted treatment for end-stage car
diac disease. To ameliorate the deconditioning that results from the p
reoperative disease state and to counteract or lessen the severity of
the sequelae of postoperative immunosuppression, physical therapists a
re active participants in the rehabilitation of cardiac transplant rec
ipients. This involvement requires a level of knowledge and understand
ing of tile surgical procedures, pharmacology, and postoperative manag
ement with which the therapist may have, heretofore, been unexposed. T
his article reviews the development of cardiac transplantation and pre
sents an overview of the current state of the art, with emphasis on pr
eoperative considerations, surgical and immediate postoperative care,
and the effects of complications on selected exercise-related response
s.