Heart transplant
What the FAA's documents say about heart transplant, in plain words, with the FAA's own words one press away.
FAA term: Heart Transplant (Cardiac Transplant, Heart Replacement)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
HEART TRANSPLANT (Cardiac Transplant, Heart Replacement) All Classes … A. 1st or 2nd class and ATCS … B. 3rd class only
Short version
The disposition table has two rows, by class.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row A1st or 2nd class, and ATCS | Defers to the FAA | FAA review |
| Row B3rd class only | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Heart transplant
- Row A · FAA review
1st or 2nd class, and ATCS. The table asks for the most recent detailed clinical progress note generated from a clinic visit with the cardiologist or cardiac surgeon which verifies the transplant has been performed. The examiner defers and submits the information to the FAA verifying the procedure and the reason it was performed.
A. 1st or 2nd class and ATCS Submit the following for FAA review: The most recent detailed Clinical Progress Note generated from a clinic visit with their cardiologist or cardiac surgeon which verifies the transplant has been performed. DEFER Submit the information to the FAA verifying the procedure and reason it was performed.
- Row B · Special Issuance
3rd class only. There is no mandatory recovery period per Public Law 114-190 May 2017, but should be released by the treating physician (the table's words). After the treating cardiologist and/or transplant surgeon has determined that the condition is stable, the table lists the evaluations to obtain and submit to the FAA for review. The examiner defers and submits the information to the FAA for a possible Special Issuance, and once all information is received, these cases are reviewed by a FAS Cardiothoracic Surgery consultant.
B. 3rd class only There is NO mandatory recovery period per Public Law 114-190 May 2017, but should be released by the treating physician. After the treating cardiologist and/or transplant surgeon has determined that the condition is stable, obtain the following evaluation(s) and submit them to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Once all information is received, these cases are reviewed by a FAS Cardiothoracic Surgery consultant.
The FAA pathways for heart transplant
- How this pathway works: Special IssuanceAuthorization for Special Issuance of a Medical CertificateRow B
- FAA reviewYour AME defers. The FAA decides.Row A
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: the progress note
For 1st or 2nd class, and ATCS.The most recent detailed progress note from a clinic visit with your cardiologist or cardiac surgeon, which verifies the transplant has been performed.
Show the FAA's words: Row A: the progress note
A. 1st or 2nd class and ATCS Submit the following for FAA review: The most recent detailed Clinical Progress Note generated from a clinic visit with their cardiologist or cardiac surgeon which verifies the transplant has been performed.
FAA source: Heart Transplant (heart replacement). FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
DEFER Submit the information to the FAA verifying the procedure and reason it was performed.
FAA source: Heart Transplant (heart replacement). FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The table asks for the most recent detailed clinical progress note generated from a clinic visit with the cardiologist or cardiac surgeon which verifies the transplant has been performed. The examiner defers and submits the information to the FAA verifying the procedure and the reason it was performed.Exam day- The table asks for the most recent detailed clinical progress note generated from a clinic visit with the cardiologist or cardiac surgeon which verifies the transplant has been performed. The examiner defers and submits the information to the FAA verifying the procedure and the reason it was performed.
Show the FAA's words: See your AME
A. 1st or 2nd class and ATCS Submit the following for FAA review: The most recent detailed Clinical Progress Note generated from a clinic visit with their cardiologist or cardiac surgeon which verifies the transplant has been performed. DEFER Submit the information to the FAA verifying the procedure and reason it was performed.
FAA source: Heart Transplant (heart replacement). FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row ADefers to the FAAFAA review
The table asks for the most recent detailed clinical progress note generated from a clinic visit with the cardiologist or cardiac surgeon which verifies the transplant has been performed. The examiner defers and submits the information to the FAA verifying the procedure and the reason it was performed.
If the examiner defersRow BDefers to the FAASpecial Issuance
After the treating cardiologist and/or transplant surgeon has determined that the condition is stable, the table lists the evaluations to obtain and submit to the FAA for review. The examiner defers and submits the information to the FAA for a possible Special Issuance, and once all information is received, these cases are reviewed by a FAS Cardiothoracic Surgery consultant.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · FAA review
1st or 2nd class, and ATCS. The table asks for the most recent detailed clinical progress note generated from a clinic visit with the cardiologist or cardiac surgeon which verifies the transplant has been performed. The examiner defers and submits the information to the FAA verifying the procedure and the reason it was performed.
A. 1st or 2nd class and ATCS Submit the following for FAA review: The most recent detailed Clinical Progress Note generated from a clinic visit with their cardiologist or cardiac surgeon which verifies the transplant has been performed. DEFER Submit the information to the FAA verifying the procedure and reason it was performed.
- Row B · Special Issuance
3rd class only. There is no mandatory recovery period per Public Law 114-190 May 2017, but should be released by the treating physician (the table's words). After the treating cardiologist and/or transplant surgeon has determined that the condition is stable, the table lists the evaluations to obtain and submit to the FAA for review. The examiner defers and submits the information to the FAA for a possible Special Issuance, and once all information is received, these cases are reviewed by a FAS Cardiothoracic Surgery consultant.
B. 3rd class only There is NO mandatory recovery period per Public Law 114-190 May 2017, but should be released by the treating physician. After the treating cardiologist and/or transplant surgeon has determined that the condition is stable, obtain the following evaluation(s) and submit them to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Once all information is received, these cases are reviewed by a FAS Cardiothoracic Surgery consultant.
If the examiner defersSpecial Issuance
The table marks Row A, 1st or 2nd class and ATCS, DEFER, with the information submitted to the FAA verifying the procedure and the reason it was performed.
The table marks Row B, 3rd class only, DEFER, for a possible Special Issuance.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row A, 1st or 2nd class and ATCS, DEFER, with the information submitted to the FAA verifying the procedure and the reason it was performed.
A. 1st or 2nd class and ATCS … DEFER Submit the information to the FAA verifying the procedure and reason it was performed.
- Reason 2
The table marks Row B, 3rd class only, DEFER, for a possible Special Issuance.
B. 3rd class only … DEFER Submit the information to the FAA for a possible Special Issuance.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
The two rows ask for different notes
Row A asks for the most recent detailed progress note, from the cardiologist or cardiac surgeon, which verifies the transplant has been performed, and names no number of days. Row B asks for a current, detailed progress note from the treating cardiologist or transplant surgeon no more than 90 days prior to the exam.
Show the FAA's words: good to know, 2
The most recent detailed Clinical Progress Note generated from a clinic visit with their cardiologist or cardiac surgeon which verifies the transplant has been performed. … 1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating cardiologist or transplant surgeon no more than 90 days prior to the AME exam.
No mandatory recovery period for 3rd class
For Row B there is no mandatory recovery period per Public Law 114-190 May 2017, but should be released by the treating physician, and the evaluations are obtained after the treating cardiologist and/or transplant surgeon has determined that the condition is stable.
Show the FAA's words: good to know, 3
There is NO mandatory recovery period per Public Law 114-190 May 2017, but should be released by the treating physician. After the treating cardiologist and/or transplant surgeon has determined that the condition is stable, obtain the following evaluation(s) and submit them to the FAA for review:
Hospital records not to send
For Row B the table says the discharge summary is the physician's, not the discharge instructions or paperwork given to the patient when leaving the hospital, and not to submit miscellaneous hospital records such as flowsheets, nursing notes, physician orders, and medication administration records.
Show the FAA's words: good to know, 4
• Discharge summary from the physician (NOT the discharge instructions/paperwork given to the patient when leaving the hospital); … • DO NOT submit miscellaneous hospital records such as flowsheets, nursing notes, physician orders, and medication administration records.
The angiogram's "both"
The angiogram item reads "Must submit both of the report(s); and" then "Actual imaging on CD in DICOM format." The table does not say what "both" refers to, and this page shows the lines as printed.
Show the FAA's words: good to know, 5
5. Coronary Angiogram [cardiac cath] performed no more than 12 months before the AME exam: • Must submit both of the report(s); and • Actual imaging on CD in DICOM format.
The stress echo's specification sheet
The stress echo is to be in accordance with the enclosed specification sheet. The table's document has no specification sheet in it, and the table does not name one.
Show the FAA's words: good to know, 6
7. Stress Echo. Graded Exercise Stress ECHO (with electrical tracings) no more than 90 days prior to the AME exam in accordance with the enclosed specification sheet.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.