Getting a 2nd (and 3rd) Opinion for Transplant?

My father is 60 years old and has end stage liver disease.  He was referred to OHSU for a liver transplant, and was turned down because of a small, previously unknown, valve defect in his heart.  A different cardiologist and several other doctors seemed surprised that this "problem" with his heart would by cause to deny him for a transplant.  His hepatolgist has been referred to University of Washington transplant center for a second opinion.

If U of W rejects my father for a transplant, how far should we go for another opinion? Do different hospitals vary in the health standards of a potential transplant patient?   They would like to try a hospital in California if U of W rejects him, but I don't know far to encourage them to go if there is really no hope. Help!

[Thomas D Schiano, MD]

i am not sure why his candidacy would be declined based on this valvular issue.  See what u of W says.  its not uncommon that one center may not feel a patient is a candidate while another one may.  if they rejected him too, i would still seek the opinion of another transplant center if in fact the valve issue is the point of contention.  good luck.

[kymo1]

Thank you, doctor. Your response gave us hope.  

I was able to find out exactly what my dad was "diagnosed" with:
Aortic valve sclerosis without significant stenosis.  
There is no treatable coronary artery disease. Today we called the cardiologist who saw him after the transplant rejection.  His nurse read the file and said the doctor went to great lengths in his notes to emphasize that he feels my dad only has this problem when he was given Dobutamine during the transplant heart stress test.  He feels strongly that this is not something my dad has on a day-to-day basis.  

In your opinion, should we make sure these notes from the cardiologist are sent to
U of W or does it make any difference to transplant centers what "outside" doctors say?

[Thomas D Schiano, MD]

definitely have these results sent to them.  as many opinions as possible will help.