Form 4 Donor Histocompatibility

Donor Histocompatibility (DHS) Record Field Descriptions

Donor Histocompatibility (DHS) records are generated as soon as the Donor Organ Disposition process is completed in DonorNet^®, or for a living donor, after Living Donor Feedback is completed in Tiedi^® and at least one organ disposition is Recovered not for Tx, Recovered for Tx but not Tx, or Transplanted. The DHS record is to be completed by the histocompatibility laboratory responsible for performing tissue typing for deceased and living donors. This record is not required for imported organs.

The DHS record must be completed within 30 days from the record generation date. See OPTN Policy 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 UNet^SM Help Desk at 1-800-978-4334.

Provider Information

Lab: The lab, from Donor Organ Disposition in DonorNet^®, displays.

OPO: The OPO, from Donor Feedback, displays.

Donor Information

Donor Name: The donor's last and first names, from Donor Feedback, displays.

UNOS Donor ID #: The donor's identification number, from Donor Feedback, displays.

Donor Type: The donor type, from Donor Feedback, displays.

Deceased indicates the donor was not living at the time of donation.
Living indicates the donor was living at the time of donation.

Donor Center Histocompatibility Typing

Donor HLA Typed: If HLA typing was performed on this donor, select Yes. If HLA typing was not performed, select No. If it is unknown if the donor was typed, select UNK. This field is required.

If Yes is selected, complete the following section. These fields are required.

Date Typing Complete Class I: Enter the date that the donor was tissue-typed by the histocompatibility laboratory for Class I antigens. Use the standard 8-digit numeric format of MM/DD/YYYY.

Target Source for Class I: Select, as appropriate, the source(s).

Peripheral Blood
Lymph Nodes
Spleen
Thymocytes
Cell lines/clonal cells
Solid Matrix
Buccal Swab
Other

Typing Method Class I: Select, as appropriate, the typing method.

Serology
DNA
Other, Specify

Select the antigens from the drop-down lists. If the second antigen at a locus is blank, select No second antigen detected. If the donor was not tested for a particular antigen, select Not tested.

Note:  If the split of an antigen is known, enter the split rather than the parent.

A Locus Codes: 1, 2, 3, 9, 10, 11, 19, 23, 24, 25, 26, 28, 29, 30, 31, 32, 33, 34, 36, 43, 66, 68, 69, 74, 80, 203, 210, 2403, 6601, 6602, Unknown, No second antigen detected, Not Tested

B Locus Codes: 5, 7, 8, 12, 13, 14, 15, 16, 17, 18, 21, 22, 27, 35, 37, 38, 39, 40, 41, 42, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 67, 70, 71, 72, 73, 75, 76, 77, 78, 81, 703, 804, 1304, 2708, 3901, 3902, 3905, 4005, 5102, 5103, 8201, Unknown, No second antigen detected, Not Tested

Bw4 HLA Codes: Positive, Negative, Not Tested

Bw6 HLA Codes: Positive, Negative, Not Tested

Cw HLA Codes: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 13, 14, 15, 16, 17, 18, No second antigen detected, Not tested, No antigen detected

Date Typing Complete Class II: Enter the date that the donor was tissue typed by the histocompatibility laboratory for Class II antigens. Use the standard 8-digit numeric format of MM/DD/YYYY.

Target Source for Class II: Select, as appropriate, the source(s).

Peripheral Blood
Lymph Nodes
Spleen
Thymocytes
Cell lines/clonal cells
Solid Matric
Multiple
Buccal Swab
Other

Typing Method Class II: Select, as appropriate, the typing method.

Serology
DNA

Other, Specify

Select the antigens from the drop-down lists. If the second antigen at a locus is blank, select No second antigen detected. If the donor was not tested for a particular antigen, select Not tested.

Note:  If the split of an antigen is known, enter the split rather than the parent.

DR Locus Codes: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 103, 1403, 1404, Unknown, No second antigen detected, Not tested

DR51 HLA Code: Positive, Negative, Not Tested

DR52 HLA Code: Positive, Negative, Not Tested

DR53 HLA Code: Positive, Negative, Not Tested

DQB HLA Codes: 1, 2, 3, 4, 5, 6, 7, 8, 9, Unknown, No second antigen detected, Not tested

DQA HLA Codes: 01, 0101, 0102, 0103, 0104, 0105, 0106, 0107, 0108, 0109, 0110, 0111, 0112, 02, 0201, 03, 0301, 0302, 0303, 04, 0401, 0402, 0403N, 0404, 05, 0501, 0502, 0503, 0504, 0505, 0506, 0507, 0508, 0509, 0510, 0511, 06, 0601, Unknown, No second antigen detected, Not tested

DPB HLA Codes: 01, 02, 0201, 0202, 03, 04, 0401, 0402, 05, 06, 08, 09, 10, 11, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61N, 62, 63, 64N, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120N, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154N, 155, 156, 157, 158, 159N, 160, 161N, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 211, 212, 213, Unknown, No second antigen detected, Not tested

DPA HLA Codes: 0103, 0104, 0105, 0201, 0202, 0401, Unknown, No second antigen detected, Not tested

Recipient of a Living Donor Information

Name: The name, from Living Donor Feedback, displays.

SSN: The number, from Living Donor Feedback, displays.

Organ Type: The type, from Living Donor Feedback, displays.

Transplant Date: The date, from Living Donor Feedback, displays.

Transplant Center: The center, from Living Donor Feedback, displays.