The total artificial heart (TAH) provides full biventricular cardiac replacement, pulsatile perfusion at flows of 7-9 L/min at low filling pressures. This allows organs that are failing to recover and for the potential cardiac recipient to become a better transplant candidate. Postimplant patients are mobile and able to go through physical rehabilitation in a hospital or at home. The risks are acceptable as shown by the authors. TAH use in more transplant centers could save lives in many transplant candidates. K E Y W O R D S transplant "Trends and outcomes following total artificial heart (TAH) as a bridge to transplant from the UNOS database" by Coyan et al. reports on 433 total artificial heart bridge to transplant (BTT) patients from 2004 to 2020. This experience was with the SynCardia TAH-t. Coyan et al. found waitlist mortality of 7.4% and that 86.6% of implanted waitlist patients were transplanted. One-year posttransplant survival was 80%. The outcomes are similar to those reported in 2004 in a muti-institutional study that led to FDA approval for the bridge to transplantation in the United States of the Syn-Cardia TAH-t. 1 In the FDA study, 79% of all study TAH recipients were transplanted, and 1-and 5-year survivals posttransplantation How to cite this article: Copeland JG, Copeland H. "It Works." Every heart transplant program should have one.