**Abstract**

Heart transplant remains the gold standard of end-stage heart failure treatment. The number of heart transplants performed each year has increased and the number of recipient candidates has been increasing even more. As a result, recipients are now matched with donors over longer distances with increasing organ ischemic time. Organ preservation strategies have been evolving to minimize ischemia reperfusion injury following longer ischemic times. This chapter will include updated organ donation and preservation techniques for heart transplant including organ donation after brain death (DBD) and donation after circulatory death (DCD). The expansion of cardiac donation after circulatory death (DCD) and new techniques for heart preservation may increase the use of hearts from extended criteria donors and thus expand the heart donor pool.

**Keywords:** heart preservation, heart transplant, heart perfusion, heart donation, organ preservation
