Phase diagram of the entire communication procedure. When the Transplant Coordination Center identifies a marginal aged Donor, the cardiologist where the donation takes place is alerted, performs resting echocardiography and when normal, stress echo. At the end of the stress echo the cardiologist of the recruiting center fills out a standard stress echo report; after that he/she selects and stores 4 cineloops (resting and stress echo) on any storage media (CD, memory pen) and transfers cineloops to a standard computer connected with the Internet. By the computer he/she logs into the transplant website and fills out resting echo and stress echo forms on the website. After completing all operations the cardiologist clicks the end of operations. The web site automatically transfers reports and images to the central server in Pisa and automatically the cardiologist of the central echo lab in Pisa is alerted by sms and e mail. Once alerted, the Pisa cardiologist opens the website, reads peripheral echo lab reports and views resting and stress echo cine loops. The Pisa cardiologist will interpret the tele-echocardiograms and will make "second-opinion" decisions and final ("go - not go") green light to donation.