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Historical perspectives on cardiac transplantation: the past as prologue to challenges for the 21st century

The development of cardiac transplantation is based on experimental studies that started in the beginning of the last century. The improvement in the surgical technique for cardiac transplantation, associated with other progress in the field of cardiac surgery and a better understanding of the immune responses, allowed cardiac transplantation to become a reality for the treatment of endstage heart disease. Recent development in immunosuppressive agents and advances in cardiac surgery have meant that cardiac transplantation is not a “fantastic speculation for the future,” but a reality for the present. Thus, cardiac transplantation is performed around the world with an excellent survival rate and has become a lifesaving treatment for many patients with severe heart disease.