[The Public Health Council advice on heart transplantation; the price of progress].

The final report of the Health Council of The Netherlands on cardiac transplantation clearly demonstrates the success of the national program since 1984, after the first transplant. The 122 patients receiving transplants up till December 1988 have a good survival rate and quality of life, comparable in efficacy and costs with treatment of end-stage renal failure. The price of progress, however, must be paid. Donor organ shortage will limit expansion and costs will be competing with other health care needs, when cardiac transplantation is made available on a wider basis. Implications for patients, doctors and government are discussed.