Retransplantation of the heart is not a widely performed procedure and few centers have large series. The most common indication for heart retransoplantation is transplant graft coronary artery disease followed by acute rejection and primary graft dysfunction. The outcome after heart retransplantation is not as good as with primary transplantation, the one year actuarial survival rate is lower and there are more preoperative complications. The number of episodes of coronary artery disease is better than that of Retransplantation for rejection or primary graft failure. However, it is still inferior to that of primary heart transplantation. Because of this and the critical shortage of donor hearts, it is suggested that heart retransplantation should be limited to carefully selected patients.