Because of severe organ donor shortage, the heart transplant candidates are still require to wait for a couple of years before a heart transplantation (HTx) in Japan, even with left ventricular assist device support. However, the indication of a Japanese adult heart transplant program was scheduled to revise its age requirement to below 65, from the previous requirement of "below 60," and it is estimated that the number of patients who registered as candidates of HTx will further increase hereafter. Therefore aggressive utilization of potential cardiac allografts is encouraged to increase graft availability from a limited number of Japanese donors. In this report, we present the case of an HTx recipient of aged over 60 who received marginal cardiac allograft from a donor also over 60. Despite the allograft from a mostadvanced-age donor, the clinical course of the patient was almost favorable with no adverse events related to graft function. This case that was a high-risk HTx from a donor of advanced age to a recipient of advanced age will be a model case for future HTx recipients in Japan and will show us a potential capacity of marginal cardiac allograft from a donor of advanced age as a useful organ resource.