The number of heart transplants in France has begun to increase again in the past few years, albeit slowly. Indications for transplants must be discussed on a case-by-case basis and no contraindication should be considered absolute. Heart transplant results have not been modified by the expansion of the selection criteria for donors. The "super-urgent" list makes it possible to provide transplants for the patients at highest risk of imminent death, with encouraging results. The repercussions of "super-urgent" transplants must be analyzed regularly. Quality of life must be taken into account in the analysis of heart transplant results, just like survival. New circulatory assist devices can be offered to some patients as an alternative to transplantation.