When should the family physician contact the cardiological transplantation team

: End stage heart failure has a poor prognosis and may be treated by cardiac transplantation, which offers these seriously sick patients a good chance of survival with an usually outstanding quality of life as compared to the preoperative state. The indication for heart transplant depends on hemodynamic and symptomatic evaluation as well as functional values. Spiro-ergometric assessment of peak oxygen consumption is used by an increasing number of cardiac transplant centres in order to achieve helpful data considering the ideal timing of transplantation. Correct assessment of the measured peak oxygen uptake is only suitable after the onset of tailored treatment of chronic heart failure; moreover, thinking about timing of heart transplantation, it is requested to be well informed on the spontaneous course of the underlying disease. Availability of appropriate organs depends on logistic factors, especially ABO blood group matching. In summary, these data may provide enough information whether and when patients should be scheduled for cardiac transplant. Ambulatory chronic heart failure clinics which are part of cardiac transplant programs are specialized institutions for the investigation of the underlying cardiac disease and for the institution of an appropriate therapy as well as for continuous observation of these patients. These chronic heart failure clinics are working very closely together with general practitioners and specialists involved in the treatment of these patients.