Rest and stress cineloops stored on the server. Normal stress echo of a marginal donor. When the Network for Organ Sharing identifies a marginal aged donor, the local cardiologist is alerted; he performs rest (upper panels) and stress-echo (lower panels, peak stress). At the end of the procedure the cardiologist selects and transfers the four cineloops to the core lab. In this example of normal stress echo of a marginal donor, the wall motion was normal at baseline and at peak stress (WMSI = 1 at baseline and peak stress), without signs of stress-inducible ischemia. The pressure/volume relation was 8 mmHg/ml/m2 at baseline, increasing to 14 mmHg/ml/m2 at peak stress, demonstrating the absence of latent myocardial dysfunction. Based on the dipyridamole stress results, despite an age beyond the 55-year limit, the heart was chosen for orthotopic heart transplantation, and was explanted using standard technique.