Aim: to evaluate the immediate results of reconstruction of the valve heart apparatus and the great vessels of the heart graft before implantation.Materials and methods. The analysis included 24 cardiac transplants with pathology of the valve apparatus and the great vessels, as well as 24 recipients who needed emergency heart transplantation and were in the clinic under UNOS status code 1A and 1B.Results. Before performing heart transplantation, the valve apparatus and great vessels were corrected.Conclusion. With a shortage of donor organs for recipients requiring emergency care, cardiovascular transplantation from “suboptimal” donors is one of the most affordable ways. Given the possibility of reconstructive operations on the valve apparatus and the great vessels of the donor heart, and evaluating satisfactory immediate results of demonstrated observations, it can be argued that the above way out would reduce urgent waitlist mortality, achieve satisfactory survival results in the early postoperative period, increase the donor resource and optimize the transplant program.