A heart transplantation is the last treatment option for patients with severe heart failure or cardiomyopathy. The severity of this operation needs an optimal intensive care. Similarly, the suppression of the immune system and susceptibility to infection of patients requires an adjustment of general nursing activities to the ICU setting. This work allows readers to create an overview of the challenges, which critical care nurses have to handle. This literature review begins with the basic principles and provides informations of the anatomy and diseases of the heart. Following, the main part shows all postoperative care measures after heart transplantation in the ICU setting. This work begins with the chapter acquisition from the operating room and ends with the transfer process to the general ward.