Cardiac transplantation has matured as a therapeutic intervention, all
owing definitive treatment of critically ill children and adults with
end-stage heart disease. The ongoing critical shortage of donor organs
continues to deny hundreds of individuals access to this intervention
. Accordingly, many of the most meaningful recent advances made in the
field of cardiac transplantation involve means of expanding our donor
pool. While current immunosuppressive regimens have been considerably
successful in the management of acute cellular rejection, management
of the problems of acute and chronic vascular rejection remains disapp
ointing. Advances in this arena remain particularly urgent for physici
ans and surgeons involved in the care of heart transplant recipients.