[Heart transplantation in Germany 2002].

After the first transplantation thirty-five years ago, heart transplantation has become an established and surgically widely standardized treatment modality for patients with end-stage heart failure. The improved medical therapy and alternative treatment options like revascularisation (CABAG), electrical resynchronization by a three-chamber pacemaker system or the implantation of mechanical assist device systems as well as the development of risk factor score systems to calculate the prognosis of patients with heart failure requires a new assessment of the indication for heart transplantation. The large number of heart transplanted patients and the results of randomized studies with new immunosuppressive drugs allow to calculate the risk, benefit and limitation of transplantation with relatively good reliability. These experiences and knowledge obtained and the German Transplantation Law, which passed the parliament in 1999, led to the establishment of a new heart allocation system. Additionally, by the central documentation of all transplantations in Germany, it becomes possible to compare the results of heart transplantations for better quality control.