Cardiac transplantation remains a viable option for those with end-stage heart disease. In the last few years, the number of heart transplants has begun to increase slightly. Over the last 27 years, the major reasons for cardiac transplant remain coronary artery disease and dilated cardiomyopathy. Currently, heart transplants have an average lifespan of 10.5 years. The main United Network for Organ Sharing characteristics correlating with poor allograft survival include repeat transplantation, ischemic time, post-transplant dialysis, and age at the time of transplant. Data over the last two decades shows that late graft survival continues to improve slightly. This is primarily a result of a decrease in early graft failure. In heart transplant patients, we still need to find ways to stop late (>1 year post-transplant) graft loss.