We appreciate the response provided by colleagues Damman, Brügemann, De Boer, Erasmus and Van den Broek to the overview of heart transplantation at the UMCU [1] and accompanying editorial [2]. It is well taken that indeed the transplant programme at the UMCG in Groningen has developed into a strong and essential part of the total heart transplant programme in the Netherlands, and should be recognised as such. In that respect I would like to highlight that the authors nicely show that we are in the fortunate position that heart transplantation is indeed a national endeavour with equally important contributions from the three centres in Rotterdam, Utrecht and Groningen.