Imminent-Eligible Death Instructions

Imminent and Eligible Death Notification
Click on OPTN/UNOS Policy on Data Submission Requirements for additional information.
To correct information that is already displayed in an electronic record, call 1-800-978-4334.

The following data fields provide the information necessary to determine if a death notification will
provide an eligible donor or an imminent neurological death.
Provider Information
OPO: The organ procurement organization (OPO) displays. Verify the OPO name and center
code of the OPO responsible for the management of the donor and that the displayed OPO
provider number is the 6-character Medicare identification number of the OPO.
Donor Hospital: The donor hospital displays. Verify the hospital name and the 6-character
Medicare provider number of the hospital which originally referred the donor. A list of Medicare
provider numbers for your state can be obtained in the Donor Hospitals section of DonorNet.
Has consent been obtained: This data will be populated from previously entered data.
Requested by: Select the name of the person requesting the addition or modification of data.
This is an internal data field.
Time Zone: This data will be populated from previously entered data.
Is Daylight Savings Time observed: This data will be populated from previously entered data.

Status Determination
Eligibility status: This is a calculated field based on other data provided.
Imminent neurological death: this is a calculated field based on other data provided.
Ventilator support: Select Yes if the donor needed ventilator support. If the donor did not
need ventilator support select No.
Severe neurological injury: Select Yes if the donor had severe neurological injury. If the
donor did not have severe neurological injury select No.
GCS known: Select Yes if the GCS is known. If the GCS is not know select No.
Absence of brain stem reflexes: Select Yes if there is an absence of brain stem reflexes. If
there is not an absence of brain stem reflexes select No. If Yes, indicate which reflexes are
absent.
Corneal reflex
Doll’s eyes reflex
Pupillary reaction
Response to painful stimuli
Cough reflex
Gag reflex
Response to iced caloric
Spontaneous breathing

Deteriorated to cardiac death: Select Yes if the donor deteriorated to cardiac death. If the
donor did not deteriorate to cardiac death select No.
Legally declared brain dead: Select Yes if the donor was legally declared brain dead. If the
donor was not legally declared brain dead select No.
Check all the exclusions that apply:
Agranulocytosis – general
Aplastic anemia – general
Aspergillus (active) – fungal
Candidemia (active) or yeast infection (invasive) – fungal
Coccidioides (active) – fungal
CMV (active) – viral
Creutzfeldt-Jacob Disease – prion
Cryptococcus (active) – fungal
Current malignant neoplasms – general
EBNA – viral
EBV VCA IgG – viral
EBV VCA IgM – viral
Encephalitis (active) – bacterial
Encephalitis (active) – fungal
Encephalitis (active) – parasitic
Encephalitis (active) – viral
Gangrenous bowel – bacterial
HBsAg (reactive) – viral
Herpes simplex (active) – viral
Histoplasma (active) – fungal
History of melanoma – general
Hodgkins’ Disease – general
HIV – viral
HTLV I/II – viral
Immaturity (extreme) – general
Intra-abdominal sepsis – bacterial
Leishmania (active) – parasitic
Leprosy – bacterial
Leukemia – general
Lymphoma – general
Malaria/Plasmodium (active) – parasitic
Meningitis (active) – bacterial
Meningitis (active) – fungal

Meningitis (active) – parasitic
Meningitis (active) – viral
Myeloma (multiple) – general
Multi-system organ failure – general
Perforated bowel – bacterial
Pneumonia (active) – viral
Previous malignant neoplasms with current evident metastatic disease – general
Rabies – viral
Retroviral infections – viral
SARS – viral
Strongyloides (active) – parasitic
Trypanosome cruzi (active) – parasitic
Tuberculosis – bacterial
Varicella zoster (active) – viral
West Nile virus infection – viral

The following data fields will be collected based on the determination of an eligible donor or an
imminent neurological death.
Provider Information
OPO: The organ procurement organization (OPO) displays. Verify the OPO name and center
code of the OPO responsible for the management of the donor and that the displayed OPO
provider number is the 6-character Medicare identification number of the OPO.
Donor Hospital: The donor hospital displays. Verify the hospital name and the 6-character
Medicare provider number of the hospital which originally referred the donor. A list of Medicare
provider numbers for your state can be obtained in the Donor Hospitals section of DonorNet.
Date and time of pronouncement of death (Complete for brain dead and DCD donors):
Enter the date, using the standard 8-digit numeric format of MM/DD/YYYY, and time (military)
of pronouncement of death of the donor.
How did you learn of this case: Select Donor hospital notification or Retrospective review to
indicate how the case was identified.
Date of hospital notification: Enter the date of notification, using the standard 8-digit numeric
format of MM/DD/YYYY, of notification.
Has consent been obtained for organ donation: This data will be populated from previously
entered data.
Was consent requested: Select Yes if consent was requested. If consent was not requested
select No.
Reason consent not requested: Select the reason consent was not requested.
Reason consent not obtained: Select the reason consent was not obtained.
Requested by: For OPTN use. Select the person at the institution making the request.

Demographics

Last Name: This data will be populated from previously entered data.
First Name: Enter the first name of the donor who was referred to your OPO as a potential
organ donor.
ABO Blood Group: The donor's blood type. Verify the blood type displayed for the donor
referred to your OPO. Acceptable values are: A, B, AB or O. If this information is incorrect, you
may make modifications in the donor record in DonorNet. The DDR record will then be updated
with this information. If the subgroup of A is known, it can be specified: A1, A2, A1B, or A2B.
DOB/Age: These data will be populated from previously entered data.
Gender: This data will be populated from previously entered data.
Eligibility status: This field will be calculated from previously entered data and displayed.
Imminent neurological death: This field will be calculated from previously entered data and
displayed.
Cause of Death: Select the donor's cause of death. If the cause of death is not listed, select
Other, specify, and enter the cause of death in the space provided.
Anoxia
Cerebrovascular/Stroke
Head Trauma
CNS Tumor
Other Specify
Mechanism of Death: Select the donor's mechanism of death. If the mechanism of death is
not listed, select None of the Above.
Drowning
Seizure
Drug Intoxication
Asphyxiation
Cardiovascular
Electrical
Gunshot Wound
Stab
Blunt Injury
SIDS
Intracranial Hemorrhage/Stroke
Death from Natural Causes
None of the Above
Circumstances of Death: Indicate the donor's circumstances of death. If the circumstance of
death is not listed, select None of the Above.
MVA
Suicide
Homicide
Child-Abuse
Non-MVA
Death from Natural Causes
None of the Above
Unknown

Ethnicity/Race: Select as appropriate to indicate the donor's ethnicity/race.
American Indian or Alaska Native: Select for donors who are of North, South, or Central
American descent (e.g. American Indian, Eskimo, Aleutian, Alaska Indian). If the donor
belongs to the primary category, but does not belong to any of the subcategories listed,
select American Indian or Alaska Native: Other. If unknown, select American Indian or
Alaska Native: Not Specified/Unknown.
Asian: Select for donors who are of Asian descent (e.g. Asian Indian/Indian SubContinent, Chinese, Filipino, Japanese, Korean, Vietnamese). If the donor belongs to
the primary category, but does not belong to any of the subcategories listed, select Asian:
Other. If unknown, select Asian: Not Specified/Unknown.
Black or African American: Select for donors of African descent (e.g. African American,
African (Continental), West Indian, Haitian). If the donor belongs to the primary category,
but does not belong to any of the subcategories listed, select Black or African American:
Other. If unknown, select Black or African American: Not Specified/Unknown.
Hispanic/Latino: Select for donors who are of Central or South American descent (e.g.
Mexican, Puerto Rican (Mainland), Puerto Rican (Island), Cuban). If the donor belongs
to the primary category, but does not belong to any of the subcategories listed, select
Hispanic/Latino: Other. If unknown, select Hispanic/Latino: Not Specified/Unknown.
Native Hawaiian or Other Pacific Islander: Select for donors who are descendents of the
Native Hawaiian, Guamanian or Chamorro, or Samoan peoples. If the donor belongs to
the primary category, but does not belong to any of the subcategories listed, select Native
Hawaiian or Other Pacific Islander: Other. If unknown, select Native Hawaiian or Other
Pacific Islander: Not Specified/Unknown.
White: Select for donors who are of European Descent, Arab or Middle Eastern or
North African (non-Black). If the donor belongs to the primary category, but does not
belong to any of the subcategories listed, select White: Other. If unknown, select White:
Not Specified/Unknown.
Procurement and Consent
Medical Examiner/Coroner accepted case: Select Yes if the donor's death was accepted by
the medical examiner/coroner. If the donor's death was not accepted by the medical
examiner/coroner, select No.
Medical Examiner/Coroner decision: Select Consented if the medical examiner/coroner
consented for organ donation. If the medical examiner/coroner did not consent for organ
donation select Refused Consent.
Was intent to be a donor documented: Select Yes if the patient had written documentation of
their intent to be a donor. If not, select No. If unknown, select UNK.
If yes, indicate mechanisms (check all that apply): If the patient had written
documentation of their intent to be a donor, indicate whether the mechanism was a
Driver's License, Donor Card, Donor Registry and/or Durable Power of
Attorney/Healthcare Proxy. If the documentation used is not listed, enter the type of
written documentation in the Other Specify field.
Consent based only on this documentation: If consent was based solely on this
documentation, select Yes. If not, select No. If unknown, select UNK.
Did the Patient express to family or others the intent to be a donor: If the patient
expressed to family or others the intent to be a donor, select Yes. If not, select No. If unknown,
select UNK.
Tests that confirmed neurological death: Indicate the tests that confirmed neurological death
(check all that apply):

Angiography
EEG
Flow Study
Other, specify
Date and time consent obtained for first organ: Enter the date, using the standard 8-digit
numeric format of MM/DD/YYYY, and time (military) consent was obtained for first organ.

Clinical Information
Terminal Lab Data: For each of the laboratory tests listed (Serum Creatinine, BUN,
SGOT/AST and SGPT/ALT), provide the value in the units indicated from tests performed
closest to the time of recovery. If a value is unavailable, you may select the appropriate status
from the ST field (N/A, Not Done, Missing, Unknown). Indicate whether protein was found in
the urine by selecting Yes, No or UNK.
Life Style Factors
History of Hypertension: Select Yes if the donor has a documented history of hypertension
prior to this hospitalization. If the donor does not have a documented history of hypertension
prior to this hospitalization, select No. If unknown, select Unknown. If the duration is unknown,
select Yes, Unknown Duration.
No
Yes, 0-5 Years
Yes, 6-10 Years
Yes, > 10 Years
Yes, Unknown Duration
Unknown
If Yes, method of control: Select Yes, No or UNK for each method of hypertension
control listed.
Diet
Diuretics
Other hypertensive medication