Heart Transplant Evaluation

Heart Transplant Evaluation


Heart transplant surgery is the best treatment for end stage heart failure. Heart disease can be caused by a heart attack, diseased heart valves, or weakness of the heart muscle. A thorough evaluation is done to diagnose diseases that could affect your health or make your health worse after transplant. Not everyone with heart failure meets the criteria for a heart transplant.

What is a heart transplant?

A heart transplant is a surgical procedure where your weak heart is removed and replaced with a healthy donor heart. Your organ donor will be anonymous. Organ donors and recipients are matched in the United Network of Organ Sharing (UNOS). When a donor becomes available, the UNOS computer determines who will get the donated heart. This is determined by blood type, your waiting list status, height, and weight.

Tier 1 evaluation

During tier 1 evaluation, you may be asked to complete the following:

  • Colonoscopy – checks for diseases of the colon and rectum
  • Dental exam
  • Mammogram – an X-ray test that checks for breast cancer
  • Pap smear, also called a Pap test – checks for cervical cancer in women
  • 24 hour urine test – measures what is in your urine to check kidney function
  • Attend an education session
  • Complete your vaccinations

Tier 2 evaluation

During tier 2 evaluation, you are expected to complete the following:

  • Ankle-brachial index (ABI) – blood pressure in your upper and lower limbs is compared to check for differences that may indicate blockages
  • Carotid duplex – an ultrasound test that shows how well blood is flowing through the carotid arteries, which are located in your neck and supply blood to the brain
  • Pulmonary function test – measures breathing and how well your lungs are working
  • Six-minute walk test – checks how your heart and lungs respond to light exercise
  • Chest CT scan – checks for diseases of the chest organs
  • Head CT scan – checks for diseases of the brain
  • Liver ultrasound – checks the liver's blood flow
  • Bone density test – checks bone density, or hardness, to see if you are at risk for bone fractures
  • Consultations with the following:
    • Cardiologist
    • Cardiac surgeon 
    • Social worker 
    • Transplant coordinator 
    • Psychologist
    • Dietitian 
    • Pharmacist
    • Financial counselor

After the evaluation

Your results will be shared with a multidisciplinary committee. They, not your doctor or any one individual, make the decisions regarding advanced heart therapies, such as heart transplant and left ventricular assist device (LVAD).

Possible outcomes include:

  • Accepted for heart transplant and/or LVAD
  • Not accepted for heart transplant and/or LVAD 
  • Deferred
  • Additional testing or other information has been requested by the committee 

If you have other questions about heart transplant, please contact the Heart Transplant Program at 614-293-3787 or 800-538-1886. 


© 2003 – August 5, 2022, The Ohio State University Wexner Medical Center

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care. For more health information, call the Library for Health Information at 614-293-3707 or email: health-info@osu.edu.