Purpose Recovery of strength and endurance post heart transplant (HTx) has remained relatively slow. Factors that limit early rehabilitation include sternotomy precautions and corticosteroid myopathy. We propose that specialized, comprehensive rehabilitation program (COLTT) can be initiated immediately after discharge to (1) improve functional outcomes (2) decrease hospital readmission. Methods This is a retrospective analysis of 14 patients (age 20 - 71 years, mean 48 years, 12 male) post orthotropic HTx (2018 - 2020). Patients were enrolled, on average, 2.9 days after hospital discharge. COLTT is a multidisciplinary (respiratory and physical therapy), daily rehabilitation program (2.5 hours) with focus on return to function through strength, balance, and endurance training. Six-minute walk test (6MWT), 1-minute sit-to-stand (STS), left and right single leg stand (SLS) and walk speed were assessed pre- and post-COLTT: Published normative data for the outcome measures was used to establish patient goals. Enright equation was used to calculate patients' percent predicted 6MWD. Paired t-tests were used to assess pre/post gains using SPSS statistics software. Results The number of visits required to reach COLTT program goals was 18.85 visits (±7.68). 6MWT improved from 1008m (±369.3) to 1734m (±299.1), P 80% target level, based on Enright equation. In the 6 months following hospital discharge, only 2 had readmission for infection. None had readmission for deconditioning or cardiac decompensation. Conclusion Outcomes measures such as 6MWT and STS provide objective data of rehabilitation progress. Combining strength, balance, and endurance rehabilitation during COLTT reached functional outcomes near the level of healthy individuals in 19 visits on average. There were no unplanned hospitalizations attributable to COLTT. This implementation study supports that HTx recipients can be trained as healthy individuals and benefit from intensive rehabilitation shortly after surgery.