Updates on Heart Transplantation.

PURPOSE OF REVIEW: The purpose of this review is to provide a comprehensive update on recent advances in heart transplantation.

RECENT FINDINGS: Heart transplantation is now an established therapy for end-stage heart failure, though challenges still exist. However, multiple advances over the past few years will improve the survival and quality of life of heart transplant recipients. These advances include acceptance of previously considered marginal donor hearts, revisions to the donor heart allocation policy, advances in desensitization regimens, tailoring of immunosuppression regimens, and improvement in the diagnosis of rejection and allograft vasculopathy. Heart transplantation is evolving to provide better quality of life and survival to higher risk recipients with methods to broaden the donor pool, make the best use of existing organs, and refine the management of sensitization and diagnosis of rejection and allograft vasculopathy.