[Heart transplantation]

The first heart transplantation in the Nordic countries was performed at Rikshospitalet in Oslo, Norway in 1983 and the method is now accepted as a good treatment for selected patients. In this article we present a review of heart transplantation as it is practiced in our hospital. Because of donor shortage, the selection criteria are strict. It is most important that the patients are motivated and able to cooperate. They should be in heart failure class IV (III-IV) on the best medical treatment with no other treatment alternatives. Estimated survival without transplantation should be less than 6-12 months. Important contraindications are concurrent diseases with a more severe prognosis than that expected after transplantation. One-year and ten-year survival after transplantation at Rikshospitalet are 85% and 53%. The most important causes of death in the early postoperative period are rejection and infections. Later, the most frequent causes of death are accelerated coronary artery disease and cancer. Collaboration between the referring physician and the transplant centre is essential for a better prognosis for heart failure and after transplantation.