الفهرس 
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Abstract
Cardiac transplantation is a widely accepted therapy for the treatment of end-stage heart failure. Most candidates for cardiac transplantation have not been helped by conventional medical therapy and are excluded from other surgical options because of the poor condition of the heart.
Carrel and Gutherie first attempted the procedure in dogs in 1905, the next reported heart transplantation were at Mayo clinic in 1933 by Mann; these canine heart transplants were able to function until the onset of rejection at 8th day. Christian Barnard performed the first successful heart transplant in a human in 1967 in South Africa.
Now more than 5000 cardiac transplants occur each year around the world, although it is estimated that up to 50,000 people are candidates for transplantation.
A chronic shortage of suitable donor organs and an increasing demand for cardiac transplantation has led to the expansion of donor acceptance criteria, particulary with respect to donor age, as a result older donors are used with increasing frequency.
Although the standard technique represents an effective and simple method that can be performed quickly, some anatomic and physiological disadvantages have been reported, including the deformation of atrial integrity and geometry of the transplanted heart, protruding of the suture lines leaving a large atrial cavity, asynchronic donor and recipient atrial contractions, turbulent atrial flow and asynchronic opening closing of the atrioventricular valves.
The perfect immunosuppressive regimen would save many more lives than the perfect surgical technique or donor organ. Changes in immunosuppressive therapy have had a major impact on improving survival after heart transplantation, as evidenced by the decreasing number of deaths owing to rejection.
Conclusion: Cardiac transplantation can start in Egypt after approving the role of organ donation from cadavers, as all the facilities are available. Let’s hope that it will be approved soon to help patients with end stage heart failure who die due to absence of transplant in Egypt.