Transplantation versus prosthetic replacement of the heart. 
The cardiac allograft has a far superior clinical record than the mechanical device or artificial heart.  Further efforts in two-staged cardiac replacement are encouraged using, initially, an orthotopic total replacement of the nonfunctioning heart and, later, substitution by a cardiac allograft.  Orthotopic cardiac replacement with a mechanical device offers promise, but elective clinical application may be delayed for many years.