Twenty-seven years of laboratory experience in cardiac transplantation at Stanford have provided the necessary background for a moderately successful clinical program which now extends over a period of 17 years. Heart-lung transplantation, again entirely a product of intensive laboratory research, is now ready for clinical use. Certainly much work remains to be done in the area of donor tissue preservation, particularly with respect to the lungs. It appears that new and more specific immunosuppressing drugs are on the horizon, so tissue transplantation in general will be increasingly safer. Heart transplantation has come of age, and combined heart-lung transplantation is well under way.