Honoring 50 Years of Clinical Heart Transplantation in Circulation: In-Depth State-of-the-Art Review

Josef Stehlik, MD, MPH; Jon Kobashigawa, MD; Sharon A. Hunt, MD; Hermann Reichenspurner, MD, PhD; James K. Kirklin, MD


Circulation. 2018;137(1):71-87. 

In This Article

Abstract and Introduction


Heart transplantation has become a standard therapy option for advanced heart failure. The translation of heart transplantation from innovative experiments to long-term clinical success has married prescient insights with discipline and organization in the domains of surgical techniques, organ preservation, immunosuppression, organ donation and transplantation logistics, infection control, and long-term graft surveillance. This review explores the key milestones of the past 50 years of heart transplantation and discusses current challenges and promising innovations on the clinical horizon.


The roots of clinical heart transplantation can be traced to Alexis Carrel in the early 20th century. Carrel was profoundly affected by the death of French President Marie Francois Sadi Carnot in 1894 after being stabbed in the abdomen, resulting in exsanguination from a lacerated portal vein. Carrel's belief that repair of the portal vein could have been lifesaving stimulated an intense interest in vascular anastomoses.[1]