Patients with COPD may develop severe heart disease. These patients are at risk for poor outcome after heart transplant. There have been few studies analyzing pulmonary function testing (PFTs) and specific parameters that may be used to prognosticate risk after heart transplantation. Therefore, we evaluated patients who had end stage heart disease and their pre- transplant PFTs to assess for markers for poor outcome after heart transplant. Between 1997 and 2012, we evaluated 629 heart transplant patients by their PFTs. The PFT parameters were evaluated and two parameters were found to be important for prognosis. These included FEV1/FVC and DLCO. These patients were divided into four categories, FEV1/FVC <or ≥70%, DLCO <or ≥60%. Post-transplant endpoints included: intubation time, post-transplant ICU stay, 1-year freedom from pulmonary infection, 3-year survival, 3-year freedom from Cardiac Allograft Vasculopathy (CAV), 3-year freedom from Non-Fatal Major Adverse Cardiac Events (NF-MACE: Myocardial Infarction, Congestive Heart Failure, angioplasty, pacemaker/ICD, stroke) and 1-year freedom from any treated rejection. Patients who had FEV1/FVC <70% had significant prolongation of intubation time and significant reduction in 3 year survival compared to those patients with FEV1/FVC >70% . A similar finding was found for DLCO <60% (see table). PFT for patients with pulmonary disease prior to heart transplant can be a good indicator of outcome after heart transplantation. Specifically, FEV1/FVC <70% and DLCO <60% may contraindicate proceeding with heart transplant in these patients.