Table 2.

Components of the pre-transplant evaluation .

Testing	Rationale
Comprehensive history & physical examination	Rule out significant other organ dysfunction (lung, kidney, liver, coagulopathy) Potential contraindication: excessive obesity (>30% normal), major chronic disabling disease, active mental illness, substance abuse within 6 months
Cardiac tests: Coronary angiography or stress test Cardiopulmonary stress test Right heart catheterization	Rule out reversible disease Rule out severe, fixed pulmonary hypertension (contraindication)
Pulmonary studies: chest x-ray ± CT, pulmonary function tests	Potential contraindication: severe lung disease (consider heart-lung transplantation if appropriate)
Vascular studies (as needed): ankle-brachial index, carotid ultrasound, brain imaging	Potential contraindication: severe peripheral vascular disease, severe cerebrovascular disease
Cancer screening, age-appropriate: colonoscopy, prostate specific antigen, mammography, PAP smear, chest and abdominal imaging	Potential contraindication: malignancy within previous 2 years
Consultations with transplant nurse coordinator, social worker, psychologist, dietician, financial counselor, others as needed (e.g., dental)	Potential contraindication: noncompliance, lack of social support, lack of insurance
Various blood studies: Serologies and antibody titers: viral hepatitis, HIV, RPR; toxoplasma, CMV, EBV, HSV, VZV Immunohistocompatibility: human leukocyte antigens, panel of reactive antibodies ABO blood type	Potential contraindication: Active infection. Future need for immunizations and antimicrobial prophylaxis. Future risk of rejection For transplant listing