**4.2 Indications for heart transplantation and registration with the Japan organ transplantation network**

With the introduction of β-blockers and ACE inhibitors, the prognosis of severe heart failure has remarkably improved, and the eligibility criteria for heart transplantation have been reexamined. In Japan, the system is such that a patient is registered in the Japan Organ Transplantation Network after it has been approved through a two-step review by the transplant institution's adaptation review committee and the Japanese Circulation Society Heart Transplantation Adaptation Review Subcommittee.
