Physiology of the transplanted heart.

The success of cardiac transplantation has allowed for the development of a growing body of evidence regarding the function of the denervated heart, as well as provided insight into the function of the normally innervated heart. An appreciation of the basic physiology and pathophysiology of the denervated, transplanted human heart allows for a rational approach to the perioperative management of cardiac allograft recipients. Understanding the importance of preload, the alteration in the control of heart rate, the altered response to exercise, and potential for coronary artery disease, diastolic dysfunction, and chronic hypertension should assist clinicians in the care of these patients.