[Heart transplantation. Developments up to now and prognosis]

The future of heart transplantation in the surgical treatment of endstage cardiac disease is very promising, although the limitations imposed by coronary artery occlusion and the toxic adverse effects of immunosuppressive agents have not yet been completely overcome. The use of monoclonal antibodies both as initial rejection prophylaxis and as treatment for rejection shows encouraging results. The success of the last few years is based on a number of individual improvements: modified immunosuppressive treatment, refined selection of receivers and donors, new methods of early diagnosis of rejection episodes, precise postoperative control of the patients. The 1-year-survival rate could be raised to 85%-90%, the 5-year-survival rate to 70% and more. The significance of heart transplantation will increase, the long term prognosis will improve.