A total of 150 patients underwent cardiac transplantation at Stanford between January 1968 and August 1978. Sixty-two patients were alive at the end of this period, when the expected one-year survival rate was 70%, with an attrition rate of roughly 5% thereafter. Changes in postoperative managment resulting from continuing research contributed to improved survival rates. The results are equal or superior to those for recipients of renal transplants from unrelated donors. Major centres that have suitably trained staff and appropriate facilities for cardiac surgery should perhaps reconsider cardiac transplantation as an alternative to death in certain patients.