Evolving Areas in Heart Transplantation.

It has been 50 years since Dr. Christiaan Barnard performed the first human-to-human heart transplant in December 1967 in South Africa. Remarkable progress has been made since that time, including changes in surgical techniques, immunosuppression, donor and recipient selection, and post-transplant care. In this paper, we provide a perspective on the changing face of heart transplantation and highlight key evolving areas. Topics that are covered include advances in immunosuppression, screening for acute and chronic rejection, cardiac allograft vasculopathy, and ongoing advancements in cardiac replacement therapy, including xenotransplantation, stem-cell research, tissue engineering, and the total artificial heart.