**Abstract**

Heart failure is a chronic condition that many patients must treat with cutting-edge treatments. Worldwide population growth has increased the demand for various treatments, including heart transplantation. In order to meet the rising demand for such therapy, it was necessary to investigate both local and international options to tackle the increasing rate of HF in the Middle East Region. Local attitudes and perceptions regarding organ donation and transplantation are shifting in tandem with this process. This well-established intervention is not very popular in the Middle East as there are only a few centers that provide this service. We hereby discuss the background and Strategies for heart transplantation requirements, logistics, and implementation in Middle East countries.

**Keywords:** heart transplantation, regular multidisciplinary review committee, heart donation after brain death, heart donation after circulatory death, ventricular assistant devices
