Heart transplantation still remains the only form of treatment for patients suffering from terminal heart failure as the result of diffuse myocardial disease. The lack of enthusiasm for this operation has no scientific or moral basis. Our own limited experience and the much wider experience of other workers in this field show that with proper patient and donor selection and careful postoperative management, the results of this operation compare very favourably with those of any transplantation of other organs and in the surgical treatment of other types of terminal diseases.