A heart transplant is at present considered the
treatment of choice in cases of terminal cardiac insufficiency
refractory to medical or surgical treatment. Due
to factors such as the greater life expectancy of the
population and the more efficient management of acute
coronary syndromes, there is an increasing number of
people who suffer from heart failure. It is estimated
that the prevalence of the disease in developed countries
is around 1%; of this figure, some 10% are in an
advanced stage and are thus potential receptors of a
heart transplant. The problem is that it is still not possible
to offer this therapeutic form to all of the patients
that require it. Consequently, it is necessary to optimise
the results of the heart transplant through the
selection of patients, selection and management of
donors, perioperative management and control of the
disease due to graft rejection. Since the first transplant
carried out in 1967, numerous advances and changes
have taken place, which has made it possible to
increase survival and quality of life of those who have
received a new heart. In this article we review the most
relevant aspects of the heart transplant and the challenges
that are currently faced
