Cardiac transplants have emerged as life-extending procedures for patients with diseased hearts. Their frequency has increased over the past decade. Evaluation of the clinical course of these patients has revealed trends toward development of gastrointestinal complications which involve the upper and lower gastrointestinal tracts as well as the accessory organs. This article will discuss the complications that have been seen in the post-cardiac transplant patient as reported at Saint Joseph's Hospital of Atlanta. A more detailed discussion of opportunistic infections caused by immunosuppression therapy will be presented since these are the major complications seen in this institution. This article will share this institution's practice in regard to caring for the cardiac transplant patient. Nursing implications relating to the GI endoscopy specialty will be included. Our experience has shown that although these complications are common, they may be managed effectively through early evaluation with attention to the special needs of the immunocompromised endoscopy candidate.