Investigation/Date	Findings
Echo 19/03/2013	LVEF 67%; normal baseline function
Echo 12/09/2013	LVEF 53% (decline associated with acute rejection episode)
Echo 18/09/2013	LVEF 50% (nadir during rejection)
Echo 07/2024	LVEF 68%; normal RV size and function; normal filling pressures —full recovery to baseline
Echo 14/05/2026 (focused)	EF 64% —preserved systolic function confirmed at most recent clinic review
MPS 10/2022	No inducible ischaemia
MPS 05/2025	Normal-sized left ventricle; preserved EF 75%; no evidence of stress-induced perfusion abnormality
CTCA 07/2024	Progressive calcification in LAD; increasing stenosis in ostial circumflex artery; mild stenosis in RCA and left main stem —consistent with progressive CAV
HLA 11/2021	HLA antibody negative
HLA 07/2024	HLA positive; no donor-specific antibodies (DSA) identified
DSA 12/05/2025	DSA negative
Chest symptoms (05/2026)	Burning and tightness; early morning/positional onset; 10 min; relieved by sitting forwards; atypical of angina. Repeat MPS deferred; telephone review in 1 month.