Figure 1.

The perfect situation for transplantation would be an ideal donor organ (+) being transplanted into an ideal recipient (+) with minimal co-morbidities and expected great outcomes. In contrast, a marginal donor organ (–) should not be used in recipient with multiple co-morbidities (–).The gray area in transplantation occurs when there is a mismatch between either an ideal donor (+) and non-ideal recipient (–) or vice versa with a non-ideal donor (–) with an ideal, relatively healthy recipient (+). An understanding of the following concepts are mandatory to provide the framework for acceptance of donor hearts and to provide the best organ-recipient matching to provide optimal outcomes.