Cardiac transplantation now is a proven, effective surgical procedure for people with end stage heart disease. Heart transplant recipients confront several adaptive tasks, including dealing with the loss of the old heart, psychic acquisition of the new heart, fear of physiological rejection of the new heart and death, and spiritual concerns related to themes of resurrection and rebirth. In addition, heart transplant recipients and their caretakers need to give up patient and caretaker roles and establish roles and relationships based on the recipients' restored health. This is difficult for some people. A theory which underscores the metaphoric meaning of the heart, symbolic interaction, provides a useful framework for thinking about the heart transplantation process.