Since February 1984, 27 isotopic cardiac transplants have been performed in 25 patients. These 25 patients were from a pool of 45 patients who were accepted into the Programme. Sixteen patients have died awaiting a transplant, and four patients are presently on the waiting list. All patients accepted for cardiac transplantation were NYHA Class IV. There were 136 referrals during this period for cardiac transplantation, and 14 referrals for heart-lung transplantation. The commonest reason for non-acceptance into the Programme is that patients were considered not to be ill enough and to have a prognosis of more than six months. Patient selection is a key factor in ensuring a successful outcome with cardiac transplantation.