Abstract： Orthotopic heart transplantation was successfully performed on one patients with endstage dilated cardiomyopathy.The patient has been survived for more than 1 year until today and is now living well.The immunosuppressive therapy and the acute rejective surveillance for 1 year after operation were detailedly introduced and discussed in this paper.In the second week and sixteenth week after operation,two episodes of acute cardiac rejection occurred and were promptly treated well with methylprednisolone.