OPTN- Living Donor Registration

Living Donor Registration (LDR) Record Field
Descriptions
Living Donor Registration (LDR) records are generated as soon as the Living Donor Feedback process
is completed by the Transplant Center. The LDR record is completed for all living organ donors. This
includes kidney, segmental liver, heart, single lung, lung lobe, sectional pancreas, sectional intestine
and domino whole liver donors.
Complete the LDR record at hospital discharge or six weeks post donation, whichever is first.
Note: If the procedure was aborted, and the organ was not recovered, you are only required to
complete the Donor, Pre-Donation Clinical and Surgical Information sections below.
The LDR record must be completed within 60 days from the record generation date. See OPTN/UNOS
Policies for additional information. Use the search feature to locate specific policy information on Data
Submission Requirements.
To correct information that is already displayed in an electronic record, call the UNOS Help Desk at 1800-978-4334.
Provider Information
Recipient Center: The Recipient Center information reported in the Living Donor Feedback in TIEDI®
will display. Verify that the displayed transplant center is the hospital where the transplant operation
was performed. The provider number printed in the record is the 6-character Medicare identification
number of the hospital.
Donor Information
Donor Name: Verify the last name, first name and middle initial, if applicable, of the living donor is
correct. If the information is incorrect, corrections may be made to the Living Donor Feedback record.
UNOS Donor ID#: Each living donor is assigned a unique donor identification number when the donor
information is entered into the Living Donor Feedback record. For more information about Donor IDs,
see Donor ID Information.
Note: For resident alien donors, you must complete their US Address, Home City, State and Zip
Code. For non-resident alien donors, complete their Address, Home City and Home and
Work Phone number.
Address: Enter the street address where the donor lived before hospitalization for recovery of this
organ. (This is a required field.)
Home City: Enter the name of the city where the donor lived before hospitalization for recovery of this
organ. If the donor does not live in the United States, enter the city and country of residence. (This is a
required field.)
State: Select the name of the state where the donor's home city is located. (List of State codes) In the
event the donor is a foreign national, this field may be left blank or FOREIGN COUNTRY may be
selected, if applicable.
Zip Code: Enter the U.S. Postal Zip Code of the location where the donor lived before hospitalization
for recovery of this organ. In the event the donor is a foreign national, this field may be left blank.
Home Phone: Enter the donor's home phone number. (This is a required field.)
Work Phone: Enter the donor's work phone number.
Email: Enter the donor's e-mail address.
SSN: Enter the donor's social security number. (This is a required field.)

Note: If a living donor does not have a social security number, contact the Organ Center at 1-800292-9537 for a 9FN or 9CH number.
Date of Birth: Enter the date the donor was born using the standard 8-digit numeric format of
MM/DD/YYYY. (This is a required field.)
Gender: Select the appropriate choice to indicate if the donor is male or female. (This is a required
field.)
Marital Status at time of Donation: Select the donor's marital status from the drop-down list. (This is a
required field.) (List of Marital Status codes)
Single
Married
Divorced
Separated
Life Partner
Widowed
Unknown
ABO Blood Group: Select the donor's blood type by clicking on the circle to the left of the blood type.
(This is a required field.) (List of ABO Blood Type codes)
O
A
B
AB
Note: If the subgroup of A is known, it can be specified: A1, A2, A1B, or A2B.
Donor Type: Select the relationship of the living donor to the recipient from the drop-down list. (This is
a required field.) (List of Donor Type codes)
Biological, blood related Parent - including blood related mother, blood related father
Biological, blood related Child - including blood related son, blood related daughter (NOT
adopted child, NOT step-child)
Biological, blood related Identical Twin - including blood related brothers, blood related sister
Biological, blood related Full Sibling - including blood-related sister or blood related brother with
whom you share both parents
Biological, blood related Half Sibling - including blood-related sister or blood related brother with
whom you share one parent
Biological, blood related Other Relative: Specify - including blood related aunt, uncle,
grandparent, grandchild, cousin, niece, nephew (NOT those related to you "by marriage"). Specify
in the space provided.
Non-Biological, Spouse: including husband, wife
Non-Biological, Life Partner - refers to a non-married, long-term partner of either gender
Non-Biological, Unrelated: Paired Donation - occurs when a person may want to donate an
organ to a relative or a friend but cannot because their blood types or tissue types do not match. If
another pair in the same predicament is found, a paired donation may be possible. (Two living
donor transplants)
Non-Biological, Unrelated: Non-Directed Donation (Anonymous) - altruistic donor, stranger,
anonymous donor, good Samaritan donor
Non-Biological, Living/Deceased Donation - occurs when a non-matching relative or friend
donates a kidney to the general waiting list pool, then the relative or friend of the living donor has
priority on the waiting list for a deceased kidney. (One living transplant; one deceased transplant)

Non-Biological, Unrelated Domino - occurs when an unrelated living donor receives a heart or
whole liver transplant, then donates their heart or liver to an unrelated heart or whole liver
candidate.
Non-Biological, Other Unrelated Directed Donation: Specify - including adopted child, adopted
parent or grandparent, any relative by adoption, friend, co-worker, in-law, god-children, godparents, relative by marriage, anyone NOT blood-related and NOT your spouse. Specify in the
space provided.
Ethnicity/Race: Select all origins that indicate the donor’s ethnicity/race. (This is a required field.) (List
of Ethnicity/Race Codes)
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 Sub-Continent,
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.
Citizenship: Select as appropriate to indicate the donor's citizenship. (This is a required field.) (List of
Citizenship codes)
U.S. Citizen:Select if the donor is a U.S. Citizen by birth or naturalization.
Resident Alien:Select if the donor is a non-U.S. citizen currently residing in the United States (e.g.,
Permanent Resident, Conditional Resident, Returning Resident). A Permanent Resident is an
individual residing in the U.S. under legally recognized and lawfully recorded residence as an
immigrant. A Conditional Resident is any alien granted permanent resident status on a conditional
basis (e.g., a spouse of a U.S. Citizen; an immigrant investor), who is required to petition for the
removal of the set conditions before the second anniversary of the approval of the conditional
status. A Returning Resident is any lawful permanent resident who has been outside the United
States and is returning to the U.S., also defined as a "special immigrant".
Non-Resident Alien, Year Entered US: If the donor is a Non-Resident Alien (Nonimmigrant), enter
the year the donor entered the United States. A Nonimmigrant is an alien who seeks temporary
entry to the United States for a specific purpose. The alien must have a permanent residence
abroad and qualify for the nonimmigrant classification sought. The nonimmigrant classifications
include: foreign government officials, visitors for business and for pleasure, aliens in transit through

the U.S., treaty traders and investors, students, international representatives, temporary workers
and trainees, representatives of foreign information media, exchange visitors, fiance(e)s of U.S.
citizens, intracompany transferees, NATO officials, religious workers, and some others. Most nonimmigrants can be accompanied or joined by spouses and unmarried minor (or dependent)
children.
Note: Permanent residence begins on the date the donor was granted permanent resident
status. This date is on the donor's Permanent Resident Card (formerly known as Alien
Registration Card). To view a sample card, go to http://www.greencardus.org/images/greencard.gif.
Highest Education Level: Select the choice which best describes the living donor's highest level of
education. (This is a required field.) (List of Education codes)
None
Grade School (0-8)
High School (9-12) or GED
Attended College/Technical School
Associate/Bachelor Degree
Post-College Graduate Degree
N/A (< 5 Yrs Old)
Unknown
Did the donor have health insurance: If the donor had health insurance at the time of donation, select
Yes. If not, select No. If unknown, select UNK. (This is a required field.)
Functional Status: Select the choice that best describes the donor's functional status just prior to the
time of donation. (This is a required field.) (List of Functional Status codes)
Note: The Karnofsky Index will display for adult donors aged 18 and older.
100% - Normal, no complaints, no evidence of disease
90% - Able to carry on normal activity: minor symptoms of disease
80% - Normal activity with effort: some symptoms of disease
70% - Cares for self: unable to carry on normal activity or active work
60% - Requires occasional assistance but is able to care for needs
50% - Requires considerable assistance and frequent medical care
40% - Disabled: requires special care and assistance
30% - Severely disabled: hospitalization is indicated, death not imminent
20% - Very sick, hospitalization necessary: active treatment necessary
10% - Moribund, fatal processes progressing rapidly
Unknown
Note: The Lansky Scale will display for pediatric donors aged 1 to 17.
100% - Fully active, normal
90% - Minor restrictions in physically strenuous activity
80% - Active, but tires more quickly
70% - Both greater restriction of and less time spent in play activity
60% - Up and around, but minimal active play; keeps busy with quieter activities
50% - Can dress but lies around much of day; no active play; can take part in quiet
play/activities
40% - Mostly in bed; participates in quiet activities
30% - In bed; needs assistance even for quiet play
20% - Often sleeping; play entirely limited to very passive activities
10% - No play; does not get out of bed
Not Applicable (patient < 1 year old)
Unknown
Physical Capacity (check one): Select the choice that best describes the donor's physical capacity
just prior to the time of donation. (This is a required field.) (List of Physical Capacity codes)

No Limitations
Limited Mobility
Wheelchair bound or more limited
Unknown
Physical Capacity is the ability to perform bodily activities such as walking, dressing, bathing,
grooming, etc.
Working for income: (Complete for donors 19 years of age or older.) If the donor was working for
income just prior to the time of donation, select Yes. If not, select No. If unknown, select UNK. (This is
a required field.)
If Yes: If Yes is selected, select the donor's working status from the drop-down list. (List of Working
codes)
Working Full Time
Working Part Time due to Disability
Working Part Time due to Insurance Conflict
Working Part Time due to Inability to Find Full Time Work
Working Part Time due to Donor Choice
Working Part Time Reason Unknown
Working, Part Time vs. Full Time Unknown
If No, Not Working Due To: If No is selected, select the reason from the drop-down list. (List of
Not Work Reason codes)
Disability - A physical or mental impairment that interferes with or prevents a donor from
working (e.g. arthritis, mental retardation, cerebral palsy, etc.).
Insurance Conflict - Any differences between a donor and insurance company that prevent
them from working.
Inability to Find Work - The lack of one's ability to find work (e.g. lack of transportation, work
experience, over qualification, unavailable work, etc.).
Donor Choice - Homemaker - A donor who chooses to manage their own household instead
of performing work for pay.
Donor Choice - Student Full Time/Part Time - A donor who is enrolled in and/or participating
in college.
Donor Choice- Retired - A donor who no longer has an active working life such as an
occupation, business or office job.
Donor Choice - Other - Any reason not listed above that would prevent a donor from working.
Unknown
Pre-Donation Clinical Information
Viral Detection:
Have any of the following viruses ever been tested for: Indicate whether the donor was tested
for HIV, CMV, HBV, HCV or EBV prior to the donation by selecting Yes or No. (This is a required
field.)
If Yes is selected, indicate which viruses the donor was tested for prior to donation.
HIV (Human Immunodeficiency Virus) - Any of several retroviruses and especially HIV-1 that
infect and destroy helper T cells of the immune system causing the marked reduction in their
numbers that is diagnostic of AIDS. If Yes is selected, complete the following fields:
Was there was clinical disease (ARC, AIDS): If the donor had clinical disease, select Yes.
If not, select No. If unknown, select UNK.
Antibody: Select the result of the test.
RNA: Select the result of the test.

CMV (Cytomegalovirus) - A herpes virus (genus Cytomegalovirus) that causes cellular
enlargement and formation of eosinophilic inclusion bodies especially in the nucleus and that
acts as an opportunistic infectious agent in immunosuppressed conditions (as AIDS). If Yes is
selected, complete the following fields:
Was there was clinical disease: If the donor had clinical disease, select Yes. If not, select
No. If unknown, select UNK.
IgG: Select the result of the test.
IgM: Select the result of the test.
Nucleic Acid Testing: Select the result of the test.
Culture: Select the result of the test.
HBV (Hepatitis B Virus) - A sometimes fatal hepatitis caused by a double-stranded DNA virus
(genus Orthohepadnavirus of the family Hepadnaviridae) that tends to persist in the blood serum
and is transmitted especially by contact with infected blood (as by transfusion or by sharing
contaminated needles in illicit intravenous drug use) or by contact with other infected bodily fluids
(as during sexual intercourse) -- also called serum hepatitis. If Yes is selected, complete the
following fields:
Was there was clinical disease: If the donor had clinical disease, select Yes. If not, select
No. If unknown, select UNK.
Liver Histology: Select the result of the test.
Core Antibody: Select the result of the test.
Surface Antigen: Select the result of the test.
HBV DNA: Select the result of the test.
HCV (Hepatitis C Virus) - A disease caused by a flavivirus that is usually transmitted by
parenteral means (as injection of an illicit drug, blood transfusion, or exposure to blood or blood
products) and that accounts for most cases of non-A, non-B hepatitis. If Yes is selected,
complete the following fields:
Was there was clinical disease: If the donor had clinical disease, select Yes. If not, select
No. If unknown, select UNK.
Liver Histology: Select the result of the test.
Antibody: Select the result of the test.
RIBA: Select the result of the test.
HCV RNA: Select the result of the test.
EBV (Epstein-Barr Virus) - A herpesvirus (genus Lymphocryptovirus) that causes infectious
mononucleosis and is associated with Burkitt's lymphoma and nasopharyngeal carcinoma -abbreviation EBV; called also EB virus. If Yes is selected, complete the following fields:
Was there was clinical disease: If the donor had clinical disease, select Yes. If not, select
No. If unknown, select UNK.
IgG: Select the result of the test.
IgM: Select the result of the test.
EBV DNA: Select the result of the test.
Pre-Donation Height and Weight
Height: Enter the height of the living donor prior to donation in the appropriate space, in feet and
inches or centimeters. If the living donor's height is not available, select the appropriate (ST) dropdown list (Missing, Unknown, N/A, Not Done). (This is a required field.) (List of Status codes)
Weight: Enter the weight of the living donor prior to donation in the appropriate space, in pounds or
kilograms. If the living donor's weight is not available, select the reason from the status (ST) dropdown list (Missing, Unknown, N/A, Not Done). (This is a required field.) (List of Status codes)
History of Cancer: Indicate whether the donor had a history of cancer prior to the donation. If the
donor had a history of cancer, select the type of cancer. If not, select No. (This is a required field.) If the
type of cancer is not listed, select the Other, specify and enter the name of the cancer in the Specify
field. If the type of cancer is unknown, select Unknown. (List of Cancer Site codes)

No
Skin - Squamous, Basal Cell
Skin - Melanoma
CNS Tumor - Astrocytoma
CNS Tumor - Glioblastoma Multiforme
CNS Tumor - Medulloblastoma
CNS Tumor - Neuroblastoma
CNS Tumor - Angioblastoma
CNS Tumor - Meningioma
CNS Tumor - Other
Genitourinary - Bladder
Genitourinary - Uterine Cervix
Genitourinary - Uterine Body Endometrial
Genitourinary - Uterine Body Choriocarcinoma
Genitourinary - Vulva
Genitourinary - Ovarian
Genitourinary - Penis, Testicular
Genitourinary - Prostate
Genitourinary - Kidney
Genitourinary - Unknown
Gastrointestinal - Esophageal
Gastrointestinal - Stomach
Gastrointestinal - Small Intestine
Gastrointestinal - Colo-Rectal
Gastrointestinal - Liver & Biliary Tract
Gastrointestinal - Pancreas
Breast
Thyroid
Tongue/Throat
Larynx
Lung (Include Bronchial)
Leukemia/Lymphoma
Unknown
Other, Specify
Cancer Free Interval: If the donor had a history of cancer prior to donation, enter the number
of the years the donor was free of the cancer.(This is a required field.) If the number of years in
unknown, select the reason from the status (ST) drop-down list (Missing, Unknown, N/A, Not
Done).
History of Cigarette Use: If the donor has a history of cigarette use, select Yes. If not, select No. (This
is a required field.)
If Yes, Check # of pack years is the number of packs of cigarettes the donor smoked per day
multiplied by the number of years. For example a donor smoking 2 packs of cigarettes per day for
10 years would equal 20 pack years. (List of Pack Years codes)
0-10
11-20
21-30
31-40
41-50
>50
Unknown pack years
Duration of Abstinence: Select the number of months the donor has abstained from cigarettes. If
the time is unknown, select Unknown duration. If the donor has not stopped smoking, select
Continues To Smoke. (List of Abstinence Duration codes)

0-2 months
3-12 months
13-24 months
25-36 months
37-48 months
49-60 months
>60 months
Continues to Smoke
Unknown duration
Other Tobacco Used: If the donor has a history of other tobacco use, select Yes. If not, select No. If
unknown, select UNK. (This is a required field.)
This section displays if a kidney or lung was recovered from the donor.
Diabetes: If the donor had diabetes prior to the donation, select Yes. If not, select No. If unknown,
select UNK. (This is a required field.)
If Yes is selected, Treatment: Select the type of treatment from the drop-down list. (List of
Diabetes Treatment Codes)
Insulin
Oral Hypoglycemic Agent
Diet
Pre-Donation Liver Clinical Information
This section displays if a liver was recovered from the donor.
Total Bilirubin: Enter the most recent lab value prior to donation for total serum bilirubin in mg/dl. (This
is a required field.) If any of the data values are unavailable, select the reason from the status (ST)
drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
SGOT/AST: Enter the most recent lab value prior to donation for the serum glutamic oxaloacetic
transaminase or aspartate transaminase in U/L. (This is a required field.) If any of the data values are
unavailable, select the reason from the status (ST) drop-down list (Missing, Unknown, N/A, Not
Done). (List of Status codes)
SGPT/ALT: Enter the most recent lab value prior to donation for the Serum Glutamic Pyruvic
Transaminase/Alanine Aminotransferase in U/L. (This is a required field.) If any of the data values are
unavailable, select the reason from the status (ST) drop-down list (Missing, Unknown, N/A, Not
Done). (List of Status codes)
Alkaline Phosphatase: Enter the most recent lab value prior to donation for the serum alkaline
phosphatase value in units/L. (This is a required field.) If any of the data values are unavailable, select
the reason from the status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status
codes)
Serum Albumin: Enter the most recent lab value prior to donation for the serum albumin value in g/dl.
(This is a required field.) If any of the data values are unavailable, select the reason from the status
(ST) drop-down list (Missing, Unknown, N/A, Not Done. (List of Status codes)
Serum Creatinine: Enter the most recent lab value prior to donation for the serum creatinine value in
mg/dl. (This is a required field.) If any of the data values are unavailable, select the reason from the
status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
INR: International Normalized Ratio. Enter the most recent prior to donation ratio of the prothrombin
time (in seconds) to the control prothrombin time (in seconds). (This is a required field.) If any of the
data values are unavailable, select the reason from the status (ST) drop-down list (Missing, Unknown,
N/A, Not Done). (List of Status codes)

Liver Biopsy: If the donor had a liver biopsy prior to donation, select Yes. If not, select No. (This is a
required field.)
If Yes is selected, % Macrovesicular fat: Enter the percentage of macro vesicular fat. If the value
is not available, select the reason from the status (ST) drop-down list (Missing, Unknown, N/A,
Not Done). (List of Status codes)
Macrovesicular type - Large fat droplets balloon the liver cell, displacing the nucleus to the
periphery of the cell, like an adipocyte. Triglyceride accumulates most commonly because it
has the highest turnover rate of all hepatic fatty acid esters. Liver uptake of FFA from
adipose tissue and the diet is unrestrained, whereas FFA disposition by oxidation,
esterification, and VLDL secretion is limited.
If Yes is selected, % Micro/intermediate vesicular fat: Enter the percentage of micro/intermediate
vesicular fat. If the value is not available, select the reason from the status (ST) drop-down list
(Missing, Unknown, N/A, Not Done). (List of Status codes)
Microvesicular - Fatty liver, small fat droplets accumulate, cells appear foamy, and nuclei
are central. Triglycerides collect in subcellular organelles (i.e. endoplasmic reticulum),
reflecting widespread metabolic disturbance. Mitochondrial injury limits FFA oxidation,
while apoprotein synthesis necessary for VLDL secretion is depressed, leading to
triglyceride accumulation.
Pre-Donation Kidney Clinical Information
This section displays if a kidney was recovered from the donor.
History of Hypertension: If the donor had a history of hypertension prior to donation, select Yes and
the duration from the drop-down list. If not, select No. If unknown, select Unknown. (This is a required
field.) (List of Hypertension History codes)
No
Yes, 0 - 5 Years
Yes, 6 - 10 Years
Yes, > 10 Years
Yes, Unknown Duration
Unknown
If Yes, Method of Control: If the donor had a history of hypertension, indicate whether the method
of control was by selecting Yes, No or UNK for the following methods.
Diet
Diuretics
Other Hypertension Medication
Serum Creatinine: Enter the lab value for the kidney donor's serum creatinine value in mg/dl taken
prior to donation.(This is a required field.) If the value is not available, select the appropriate (ST) dropdown list (Missing, Unknown, N/A, Not Done). (List of Status codes)
Preoperative Blood Pressure Systolic: Enter the living donor's systolic blood pressure. (This is a
required field.) If the value is not available, select the reason from the status (ST) drop-down list
(Missing, Unknown, N/A, Not Done). (List of Status codes)
Preoperative Blood Pressure Diastolic: Enter the donor's diastolic blood pressure. (This is a required
field.) If the value is not available, select the reason from the status (ST) drop-down list (Missing,
Unknown, N/A, Not Done). (List of Status codes)
Urinalysis: Enter the donor's Urine Protein or Protein-Creatinine Ratio. (This is a required field.)
If Urine Protein is selected, select the result from the drop-down list. (List of Urinalysis Results
codes)

Positive
Negative
Unknown
Not Done
Kidney Biopsy: If the donor had a kidney biopsy prior to donation, select Yes. If not, select No. (This is
a required field.)
If Yes is selected, select the Glomerulosclerosis from the drop-down list. (List of
Glomerulosclerosis codes)
0-5
6 - 10
11 - 15
16 - 20
20+
Indeterminate
Pre-Donation Lung Clinical Information
This section displays if a lung was recovered from the donor.
FVC% predicted (Before Bronchodilators and After Bronchodilators): Enter the donor's FVC%
predicted value before bronchodilators and FVC% predicted value after bronchodilators. (This is a
required field.) If the value is not available, select the reason from the status (ST) drop-down list
(Missing, Unknown, N/A, Not Done). (List of Status codes)
FEV 1% predicted (Before Bronchodilators and After Bronchodilators): Enter the donor's FEV 1%
predicted value before bronchodilators and FEV 1% predicted value after bronchodilators. (This is a
required field.) If the value is not available, select the reason from the status (ST) drop-down list
(Missing, Unknown, N/A, Not Done). (List of Status codes)
FEF (25-75%)% predicted (Before Bronchodilators and After Bronchodilators): Enter the donor's
FEF (25-75%)% predicted value before bronchodilators and FEF (25-75%)% predicted value after
bronchodilators. (This is a required field.) If the value is not available, select the reason from the status
(ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
TLC % predicted (Before Bronchodilators and After Bronchodilators): Enter the donor's TLC%
predicted value before bronchodilators and TLC% predicted value after bronchodilators. (This is a
required field.) If the value is not available, select the reason from the status (ST) drop-down list
(Missing, Unknown, N/A, Not Done). (List of Status codes)
Diffusing lung capacity corrected for alveolar volume % predicted: Enter the % predicted value.
(This is a required field.) If the value is not available, select the reason from the status (ST) drop-down
list (Missing, Unknown, N/A, Not Done). (List of Status codes)
Pa02 on room air: Enter the value for Pa02 on room air for the donor in mm/Hg. (This is a required
field.) If the value is not available, select the reason from the status (ST) drop-down list (Missing,
Unknown, N/A, Not Done). (List of Status codes)
Liver Surgical Information
This section displays if a liver was recovered from the donor.
Type of Transplant Graft: Select the type of transplant graft from the drop-down list. (This is a
required field.) (List of Liver Graft Type codes)
Left Lateral Segment (Peds)
Left Lobe
Right Lobe
Domino Whole Liver

Kidney Surgical Information
This section displays if a kidney was recovered from the donor.
Type of Transplant Graft: The type of transplant will display from the Living Donor Feedback.
Intended Procedure Type: Select the procedure type from the drop-down list. (This is a required field.)
(List of Kidney Procedure Type codes)
Transabdominal
Flank (retroperitoneal)
Laparoscopic Not Hand-assisted
Laparoscopic Hand-assisted
Conversion from Laparoscopic to Open: If Laparoscopic was selected for Intended Procedure
Type, and there was a conversion from laparoscopic to open procedure, select Yes. If there wasn’t
a conversion, select No.
Lung Surgical Information
This section displays if a lung was recovered from the donor.
Type of Transplant Graft: The type of transplant (Lobe, Right or Lobe, Left) entered on the Living
Donor Feedback displays.
Procedure Type: Indicate whether the procedure type was Open or Video Assisted Thoracoscopic.
(This is a required field.) (List of Procedure Type codes)
Conversion from Thoracoscopic to Open: If Open was selected for Procedure Type, and there
was a conversion from thoracoscopic to an open procedure, select Yes. If there was no conversion,
select No.
Intra-operative Complications: If there were any intra-operative complications, select Yes. If not,
select No. (This is a required field.)
If Yes, Specify: Select the complication(s) by clicking on the checkbox next to the complication. If
Other Specify is selected, enter the name of the other complication in the Other Specify field. (List
of Inter-operative Complication codes)
Sacrifice of Second Lobe Specify
Anesthetic Complication Specify
Arrhythmia Requiring Therapy
Cerebrovasular Accident
Phrenic Nerve Injury
Brachial Plexus Injury
Breast Implant Rupture
Other Specify
Sacrifice of Second Lobe, Specify: If a second lobe was sacrificed, select the type from
the drop-down list. (List of Second Lobe Sacrifice codes)
RML
RUL
LUL
Lingular
Anesthetic Complication Specify: If anesthetic complication occurred, enter the
complication.
Arrhythmia requiring therapy: If there was arrhythmia requiring therapy, select the
therapy from the drop-down list. (List of Arrhythmia codes)

Medical therapy
Cardioversion
Post-Operative Information
This section displays for all organ types.
Date of Initial Discharge: Enter the date the donor was initially released to go home. Use the standard
8-digit format of MM/DD/YYYY. The donor's hospital stay includes total time spent in different units of
the hospital, including medical and rehab. (This is a required field.)
Donor Status: Select the status of the donor from the drop-down list. (This is a required field.)
Living
Dead
Date Last Seen or Death: Enter the date the living donor was last seen. If the living donor died, enter
the date of death. Use the standard 8-digit format of MM/DD/YYYY.(This is a required field.)
Cause of Death: If the living donor died, indicate the cause of death. If the cause of death is not listed,
select Other, specify and enter the cause of death in the Other specify field. (List of Cause of Death
codes)
Infection: Donation/Surgery Related
Infection: Not Donation/Surgery Related
Pulmonary Embolism
Malignancy
Domino Liver Donor-Transplant Related Death (Liver donors only)
Cardiovascular
CVA
Hemorrhage: Donation/Surgery Related
Hemorrhage: Not Donation/Surgery Related
Homicide
Suicide
Accidental
Other, specify
Non-Autologous Blood Administration: If non-autologous blood was administered to the donor,
select Yes. If not, select No. (This is a required field.) Please include any blood products given from
post-op through initial discharge.
If Yes, Number of Units: If non-autologous blood was administered to the donor, enter the number
of units the donor received for the following types:
PRBC
Platelets
FFP
Liver Related Post-Operative Complications (In First 6 Weeks Post-Donation)
This section displays if a liver was recovered from the donor.
Biliary Complications: If the donor experienced biliary complications during the first 6 weeks after
donation, select Yes. If not, select No. If unknown, select UNK. (This is a required field.)
If Yes specify: Select the grade of complication by clicking on the circle next to the grade. (List of
Biliary Complication codes)
Grade 1 - Bilious JP drainage more than 10 days
Grade 2 - Interventional procedure (ERCP, PTC, percutaneous drainage, etc.)
Grade 3 - Surgical intervention

If Grade 3 is selected, enter the Date of Surgery using the standard 8-digit format of
MM/DD/YYYY.
Vascular Complications Requiring Intervention: If the donor experienced vascular complications
requiring intervention during the first 6 weeks after the donation, select Yes. If not, select No. If
unknown, select UNK. (This is a required field.)
If Yes, Specify: Select the complication(s) by clicking on the checkbox next to the complication. If
Other, specify is selected, enter the name of the other complication in the Other Specify field.
(List of Vascular Complication codes)
Portal Vein
Hepatic Vein
Hepatic Artery
Pulmonary Embolus
Deep Vein Thrombosis
Other, Specify
Other Complications Requiring Intervention: If the donor experienced other complications requiring
intervention during the first 6 weeks after the donation, select Yes. If not, select No. If unknown, select
UNK. (This is a required field.)
If Yes, Specify: Select the complication(s) by clicking on the checkbox next to the complication. If
Other, specify is selected, enter the name of the other complication in the Other Specify field.
(List of Other Complication codes)
Renal insufficiency requiring dialysis
Ascites
Line or IV complication
Pneumothorax
Pneumonia
Wound Complication
Brachial Nerve Injury
Other, specify
Reoperation: If the donor required reoperation the first 6 weeks after the donation, select Yes. If not,
select No. If unknown, select UNK. (This is a required field.)
If Yes, specify reason for reoperation (during first six weeks): Specify the reason(s) by clicking
on the checkbox next to the reason. Enter the Date for each reason selected using the standard 8digit format of MM/DD/YYYY. If Other Specify is selected, enter the reason and the Date.
Liver Failure Requiring Transplant
Bleeding Complications
Hernia Repair
Bowel Obstruction
Vascular Complications
Other Specify
Any Readmission After Initial Discharge: If the donor required any readmission after the initial
discharge during the first 6 weeks after the donation, select Yes. If not, select No. If unknown, select
UNK. (This is a required field.)
If yes, specify reason for readmission (during first six weeks): Select the reason from the dropdown list. If Other, specify is selected, enter the reason in the Specify field. (List of Readmission
codes)
Wound infection
Fever
Bowel Obstruction
Pleural Effusion
Biliary Complications

Vascular Complications
Other, specify
If Yes, Date of First Readmission: Enter the date of the first readmission using the standard 8digit format of MM/DD/YYYY.
Other Interventional Procedures: If the donor required other interventional procedures during the first
6 weeks after the donation, select Yes. If not, select No. If unknown, select UNK. (This is a required
field.)
If Yes, Specify Procedure: Enter the procedure.
Date of Procedure: Enter the date of the procedure using the standard 8-digit format of
MM/DD/YYYY.
Kidney Related Post-Operative Complications (In First 6 Weeks Post-Donation)
This section displays if a kidney was recovered from the donor.
Vascular Complications Requiring Intervention: If the donor experienced vascular complications
requiring intervention during the first 6 weeks after the donation, select Yes. If not, select No. If
unknown, select UNK. (This is a required field.)
If Yes, Specify: Select the complication(s) by clicking on the checkbox next to the complication. If
Other, specify is selected, enter the name of the other complication in the Other Specify field.
(List of Kidney Vascular Complication codes)
Renal Vein
Renal Artery
Aorta
Vena Cava
Pulmonary Embolus
Deep Vein Thrombosis
Other, specify
Other Complications Requiring Intervention: If the donor experienced other complications requiring
intervention during the first 6 weeks after the donation, select Yes. If not, select No. If unknown, select
UNK. (This is a required field.)
If Yes, Specify: Select the complication(s) by clicking on the checkbox next to the complication. If
Other, specify is selected, enter the name of the other complication in the Other Specify field.
(List of Other Kidney Complications codes)
Renal insufficiency requiring dialysis
Ascites
Line or IV complication
Pneumothorax
Pneumonia
Wound Complication
Brachial Nerve Injury
Other, specify
Reoperation: If the donor required reoperation the first 6 weeks after the donation, select Yes. If not,
select No. If unknown, select UNK. (This is a required field.)
If Yes, specify reason for reoperation (during first six weeks): Specify the reason(s) by clicking
on the checkbox next to the reason. Enter the Date for each reason selected. If Other Specify is
selected, enter the reason and the Date.
Bleeding
Hernia Repair
Bowel Obstruction

Vascular
Other Specify
Any Readmission After Initial Discharge: If the donor required any readmission after the initial
discharge during the first 6 weeks after the donation, select Yes. If not, select No. If unknown, select
UNK. (This is a required field.)
If yes, specify reason for readmission (during first six weeks): Select the reason from the dropdown list. If Other, specify is selected, enter the reason in the Specify field. (List of Readmission
codes)
Wound infection
Fever
Bowel Obstruction
Pleural Effusion
Vascular Complications
Other, specify
If Yes, Date of First Readmission: Enter the date of the first readmission using the standard 8digit format of MM/DD/YYYY.
Other Interventional Procedures: If the donor required other interventional procedures during the first
6 weeks after the donation, select Yes. If not, select No. If unknown, select UNK. (This is a required
field.)
If Yes, Specify Procedure: Enter the procedure.
Date of Procedure: Enter the date of the procedure using the standard 8-digit format of
MM/DD/YYYY.
Lung Related Post-Operative Complications (In First 6 Weeks Post-Donation)
This section displays if a lung was recovered from the donor.
Post-operative complications during the initial hospitalization: If the donor experienced any postoperative complications during the initial hospitalization, select Yes. If not, select No. (This is a required
field.)
If Yes is selected, select the type of post-operative complications from the drop-down list. (List of
Post-operative Complication codes)
Arrhythmia requiring therapy
Bleeding requiring surgical or therapeutic bronchoscopic intervention
Bowel obstruction or ileus not requiring surgical intervention
Bowel obstruction or ileus requiring surgical intervention
Bronchial Stenosis/Stricture not requiring surgical or therapeutic bronchoscopic
intervention
Bronchial Stenosis/Stricture requiring surgical or therapeutic bronchoscopic
intervention
Bronchopleural Fistula requiring surgical or therapeutic bronchoscopic intervention
Cerebrovascular Accident
Deep Vein Thrombosis
Empyema requiring therapeutic surgical intervention
Epidural-Related Complication
Line or IV Complication
Loculated pleural effusion requiring surgical intervention
Pericardial tamponade or pericarditis requiring surgical intervention
Pericarditis not requiring surgical intervention
Peripheral Nerve Injury
Phrenic Nerve Injury
Placement of Additional Thoracostomy Tube(s), Specify Indication

Pneumonia/Atelectasis
Prolonged (>14 days) Thoracostomy Tube Requirement
Pulmonary Artery Embolus or Thrombosis
Pulmonary Vein or Left Atrial Thrombosis
Wound Complication
Wound infection requiring surgical intervention
Other Specify
Arrhythmia requiring therapy: Indicate if the donor received Medical therapy,
Cardioversion or Electrophysiologic Ablation. (List of Therapy codes)
Placement of Additional Thoracostomy Tube(s), Indication: Select the placement of
the tubes from the drop-down list. (List of Thoracostomy Tube codes)
Pneumothorax
Pleural effusion
Empyema
Other Specify: Enter the therapy.
Any readmission After Initial Discharge: If the donor required any readmission after the initial
discharge during the first 6 weeks after the donation, select Yes. If not, select No. If unknown, select
UNK. (This is a required field.)
If yes, specify reason for readmission (during first six weeks): Select the reason from the dropdown list. If Other, specify is selected, enter the reason in the Specify field. (List of Readmission
codes)
Wound infection
Fever
Bowel Obstruction
Pleural Effusion
Vascular Complications
Other, specify
If Yes, Date of First Readmission: Enter the date of the first readmission using the standard 8digit format of MM/DD/YYYY.
Post-Operative Clinical Information (Within 6 Weeks Post-Donation)
The following questions display for all donated organs:
Most Recent Date of Tests: Enter the date of the donor's most recent tests in the space provided
within the 6 weeks after donation using the standard 8-digit numeric format of MM/DD/YYYY.
Height: Enter the height of the donor in ft (feet) and in (inches) or cm (centimeters). (This is a required
field.) If the donor's height is not available, select the appropriate (ST) drop-down list (Missing,
Unknown, N/A, Not Done). (List of Status codes)
Weight: Enter the weight of the donor in lb (pounds) or kg (kilograms). (This is a required field.) If the
donor's weight is not available, select the reason from the status (ST) drop-down list (Missing,
Unknown, N/A, Not Done). (List of Status codes)
The following questions display for donated kidney organs only.
Serum Creatinine: Enter the lab value for the kidney donor's serum creatinine value in mg/dl taken
within 6 weeks after donation. (This is a required field.) If the value is not available, select the reason
from the status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
Post-Op Blood Pressure Systolic: Enter the donor's systolic blood pressure within 6 weeks after the
donation in the space provided. (This is a required field.) If the value is not available, select the reason
from the status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)

Post-Op Blood Pressure Diastolic: Enter the donor's diastolic blood pressure within 6 weeks after the
donation in the space provided. (This is a required field.) If the value is not available, select the reason
from the status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
Urinalysis: Enter the donor's Protein-Creatinine Ratio or Urine Protein. This is a required field.
If Urine Protein is selected, select the result from the drop-down list. (List of Urinalysis Results
codes)
Positive
Negative
Unknown
Not Done
Donor Developed Hypertension Requiring Medication: If the donor developed hypertension within 6
weeks after donation that required medication, select Yes. If not, select No. If unknown, select UNK.
(This is a required field.)
The following questions display for donated liver organs only:
Total Bilirubin: Enter the lab value for total serum bilirubin in mg/dl. (This is a required field.) If the
value is not available, select the reason from the status (ST) drop-down list (Missing, Unknown, N/A,
Not Done). (List of Status codes)
SGOT/AST: Enter the lab value for the serum glutamic oxaloacetic transaminase or aspartate
transaminase in U/L. (This is a required field.) If the value is not available, select the reason from the
status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
SGPT/ALT: Enter the lab value for Serum Glutamic Pyruvic Transaminase/Alanine Aminotransferase in
U/L. (This is a required field.) If the value is not available, select the reason from the status (ST) dropdown list (Missing, Unknown, N/A, Not Done). (List of Status codes)
Alkaline Phosphatase: Enter the lab value for the serum alkaline phosphatase value in units/L. (This
is a required field.) If the value is not available, select the reason from the status (ST) drop-down list
(Missing, Unknown, N/A, Not Done). (List of Status codes)
Serum Albumin: Enter the lab value for the serum albumin value in g/dl. (This is a required field.) If the
value is not available, select the reason from the status (ST) drop-down list (Missing, Unknown, N/A,
Not Done). (List of Status codes)
Serum Creatinine: Enter the lab value for the serum creatinine value in mg/dl. (This is a required field.)
If the value is not available, select the reason from the status (ST) drop-down list (Missing, Unknown,
N/A, Not Done). (List of Status codes)
INR: International Normalized Ratio. Enter the ratio of the prothrombin time (in seconds) to the control
prothrombin time (in seconds). (This is a required field.) If the value is not available, select the reason
from the status (ST) drop-down list (Missing, Unknown, N/A, Not Done). (List of Status codes)
Organ Recovery
Organ Recovery Date: The date of the donor's recovered organ reported in the Living Donor Feedback
will display. Verify that the displayed date is the date the organ(s) was recovered from this donor. If the
date is blank or incorrect, use the standard 8-digit numeric format of MM/DD/YYYY to enter the correct
date. If the operation was started in the evening and concluded the next day, enter the date the
operation began. (This is a required field.)
Did organ recovery and transplant occur at the same center: If the organ recovery and transplant
occurred at the same center, select Yes. If not, select No. (This is a required field.)
Organ(s) Recovered: The donor's organ(s) reported as being recovered in the Living Donor Feedback
will display. Verify the organ(s) displayed in the record are the organs recovered from this donor. Verify
that the correct organ modifier (right or left) is displayed in the record. (List of Recovered Organ codes)

Right Kidney
Left Kidney
Pancreas Segment
Liver Segment
Intestine Segment
Living Donor Heart Transplant
Right Single Lung
Left Single Lung
Left Lung Lobe
Right Lung Lobe
Domino Whole Liver
Recipient Name (Last, First): The recipient's name reported in the Recipient and Living Donor
Feedback will display. Verify that the displayed name is the name of the recipient who received this
organ.
Recipient SSN#: The recipient's social security number reported in the Recipient and Living Donor
Feedback will display. Verify the social security number of the recipient.
Donor Recovery Facility: This will default with the same center as Donor Workup Facility, but can be
changed if the organ was recovered at a different center. The drop-down list contains the names of all
national Transplant Centers. (This is a required field.)
Donor Workup Facility: This is the name of the center that entered the Living Donor information into
UNetSM. This cannot be modified.