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One-year survival rates now exceed 90% at some transplant centers. coronary artery disease, and malignancies, continue to plague long-term survival rates in this infection and rejection requires the special experitise of experienced cardiologists and immunologists. An improved understanding of the immune system promises to increase long-term survival rates of cardiac transplant recipients. Critical care nurses require special assessment skill to meet the demanding challenges of cardiac transplant recipients in the immediate postoperative period. The impact of cardiac denervation, immunosupression, and the risk for acute rejection add a different perspective for nursing interventions in the critical care environment. 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