Since 1990 the "Heart Transplant Program" has been instituted in the Piemonte Region. Until now the program had regular development according to the number of transplantations and the high quality of clinical results. Sixty heart transplantations has been performed with a 36 month survival close to 80%. Our data demonstrate that after heart transplantation prognosis of end-stage cardiac disease is highly improved either for life expectancy and for quality of life. Our program includes several aspects of scientific research from physiology to clinic, from biochemistry to immunology, from infectivology to pathology, from intensive care to surgery. Several very positive multi disciplinary investigations have been activated.