This study investigates the presence and correlates of symptoms of depression at 5 and 10 years after heart transplantation, with particular attention given to patients showing symptoms at both time points. Prevalence of depression symptoms were studied in 41 patients, prospectively, at 5 and 10 years after heart transplantation. We examined potential correlates of depression symptoms (i.e. worse functional capacity, inadequate coping mechanisms and lack of social contacts) 10 years after transplantation. The prevalence of depression symptoms was 30% at 5 years and 22% at 10 years. Of the 41 patients, 20% were depressed at both time points. Those patients had significantly higher scores on passive coping and had significantly lower club membership. They also tended to have more negative emotions (i.e. anger, hostility and irritability) and less engagement in sports activities. Functional capacity was not different. Depression symptoms were prevalent and persistent in the long-term after heart transplantation. This study opens perspectives for beyond-standard pharmacological and psychotherapeutic treatment for depression, i.e. training patients who are using passive coping to use problem-solving capacities instead and motivating them to engage in social life and sports activities.