Since February 1999, organ transplantation from a brain-dead donor has been started in Japan. For more than 3 years, 91 patients underwent organ transplantation from 22 donors. Until November 2002, 132 patients have been registered to Japan Organ Transplant Network as a heart transplant candidate and 16 and 9 underwent heart transplantation (HTx) in Japan and abroad, respectively, while 37 died during waiting. 11 of 16 HTx recipients were implanted with left ventricular assist device (LVAS: Novacor in 2, TCI-IP in 2 and NCVC in 7). all 16 HTx recipients survived until now. 4 had several rejection episodes which were treated successfully. 5 had infection episodes (pneumonia in 3 and CMV infection in 2). 13 were already discharged and 9 returned to work.