50 years have passed since the first human to human heart transplantation, 
performed by Christiaan Barnard in Cape Town December 3rd 1967. Over the years 
there has been a dramatic improvement in postoperative survival, mainly due to 
numerous diagnostic and therapeutic advances. Today, heart transplantation 
constitutes the treatment of choice among suitable patients with severe heart 
failure who worsen despite medical and surgical optimization. The world average 
10-year survival has now reached more than 58 %. This text summarizes the past, 
present and future.