HEART-TRANSPLANTATION

Increased experience and knowledge in the field of heart transplantati on has resulted in continued expansion of this clinical activity. The same experience has served to identify many problems and provided some answers which are in many instances incomplete. The outstanding probl ems in heart transplantation are firstly the availability of donor org ans, secondly, the limited storage of excised donor hearts and thirdly the conundrum of transplant vascular disease as it is manifested in t he coronary arteries of the donor heart. Despite these problems, heart transplantation remains a very effective form of treatment particular ly for young, well-motivated patients in end-stage heart failure. Alth ough there is considerable agreement on many of the issues relating to heart transplantation, there are several areas of controversy. Neonat al heart transplantation is one example, though with accumulated exper ience, acceptance of the procedure has grown. The purpose of this arti cle is to provide an overview of the present situation and to highligh t areas of controversy and ignorance which require investigation.