Heart Transplantation

Although the number of heart transplant recipients is relatively small, some recipients may wish to be commercial motor vehicle drivers. The major medical concerns for certification of a commercial driver heart recipient are transplant rejection and post-transplant atherosclerosis.

Waiting period

Minimum — 1 year post transplant

NOTE: If more than one waiting period applies (because of multiple cardiac conditions or other comorbid diseases), examine the driver for certification after the completion of the longest waiting period.

Decision

Maximum certification period — 6 months

Recommend to certify if:

The driver:

• Is asymptomatic.
• Tolerates medications.
• Has clearance from a cardiovascular specialist who understands the functions and demands of commercial driving.
• Has no signs of transplant rejection.
• Meets all other qualification requirements.

Recommend not to certify if:

As the medical examiner, you believe that the nature and severity of the medical condition endangers the health and safety of the driver and the public.

Monitoring/Testing

Monitoring the driver with a heart transplant should include re-evaluation and recertification every 6 months by a cardiovascular specialist who:

• Is an expert in the fields of cardiology and transplant medicine.
• Understands the functions and demands of commercial driving.
• Evaluates the possibility of atherosclerosis, the status of the transplant, and the general health of the driver.

Follow-up

The driver should have a medical examination every 6 months.

Heart Transplantation Recommendation Table (PDF)