Table 3.

Requested information for referral of a potential heart transplant candidate.

- Summary of the complete medical history (cardiac as well as non-cardiac)

- Actual medication and history of intolerance to medication

- Surgery report in case of prior cardiac surgery

- Heart catheterisation data (left- and right-sided pressures, cardiac output, PVR, SVR and coronary angiography)

- Evaluation of the present status of the patient:

a) Functional class and predominant symptoms/problems

b) Physical examination including peripheral/carotid vessels, and oral cavity (dental status)

c) ECG

d) Chest X-ray

e) Blood type and Rhesus factor, electrolytes, renal and liver function, glucose, ESR or CRP, Hb, white blood count and

differentiation, platelets

Serology for HBV and HCV and HIV

Urine analysis for protein, glucose and sediment

Stool tests for blood loss

f) Echocardiogram (dimensions, systolic and diastolic ventricular function, estimation of right-sided pressures, valvular

abnormalities)

g) Exercise test, preferably with determination of peak VO2

h) Pulmonary function testing