Aim. Feasibility and reliability of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Cardiac Graft (CG) on Telemedicine Systems. Material and Methods: Sensitivity-specificity analysis by a simulation of TRE of CG on 15 MR thoracic images by two radiologists and of TPE by 20 specialists based on total 100 human CG digital images, assessing injuries/trauma and lesions. Results: Integration of TRE and TPE of CG for remote diagnosis showed an accuracy for: injuries/trauma/hematoma=90.9–100%, and non-neoplastic lesions=94.3%. Conclusion: Integration of TRE and TPE of CG is feasible and reliable for Heart Pre-Grafting and Pre-Transplant decision support and planning.