OPTN- Thoracic Follow-up

Thoracic 6 Month Transplant Recipient Follow-up
(TRF) Record Field Descriptions
Transplant Recipient Follow-up (TRF) records are generated in Tiedi®at six months, one year and
annually thereafter following transplantation, until either graft failure, recipient death or lost to follow-up
is reported.
The TRF record is to be completed by the transplant center responsible for follow-up of the recipient 6
months.
Note: The record is to contain only the applicable patient information between the completion of the
TRR and the 6 month follow-up. It is not to contain information pertaining solely to the next
follow-up period. For example: the 6-month follow-up should contain information from the time
after the TRR was completed to the 6-month transplant anniversary date; the 1-year follow-up
should contain information from the day after the 6-month transplant anniversary date to the 1year transplant anniversary date.
If the recipient dies or experiences a graft failure between completion of the TRR and the 6 month
follow-up, complete an interim record containing the information pertinent to death or graft failure.
TRF records generated before June 30, 2002 are forgiven except for the one-year, three-year,
death/graft failure or most recently expected follow-up record. Amnesty records may be accessed by
selecting the Expected/Amnesty and/or Amnesty option on the Search page. (For additional
information, see Searching for Patient Records and Records Generation.)
If the patient is lost to follow-up, follow the steps for Reporting Lost to Follow-up.
The TRF record must be completed within 30 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 on an electronic record, call the UNetSM Help Desk at 1800-978-4334.
Recipient Information
Name: Verify the last name, first name and middle initial of the transplant recipient is correct. If the
information is incorrect, corrections may be made on the recipient's TCR record.
DOB: Verify the displayed date is the recipient's date of birth. If the information is incorrect, corrections
may be made on the recipient's TCR record.
SSN: Verify the recipient's social security number is correct. If the information is incorrect, contact the
Help Desk at 1-800-978-4334.
Gender: Verify the recipient's gender is correct. If the information is incorrect, corrections may be made
on the recipient's TCR record.
HIC: Verify the 9 to 11 character Health Insurance Claim number for the recipient indicated on the
recipient's most recently updated TCR record is correct. If the recipient does not have a HIC number,
you may leave this field blank.
Tx Date: The recipient's transplant date, reported in the Recipient Feedback, will display. Verify the
transplant date is the date of the beginning of the first anastomosis. If the operation started in the
evening and the first anastomosis began early the next morning, the transplant date is the date that the
first anastomosis began. The transplant is considered complete when the cavity is closed and the final
skin stitch/staple is applied.
Previous Follow-up: Transplant Recipient Registration displays.

Previous Px Stat Date: The recipient's patient status date, reported in the previous TRF record, will
display. Verify the recipient's previous patient status date is correct.
Transplant Discharge Date: Verify that the discharge date displayed is the date the recipient was
released to go home, or enter the date the recipient was released. The patient's hospital stay includes
total time spent in different units of the hospital, including medical and rehab.
Note: The Transplant Discharge Date can only be edited on the patient's TRR. The corrected
information will automatically update on the 6 month TRF record.
State of Permanent Residence: Select the name of the state, of the recipient's permanent address, at
the time of follow-up. This is a required field. (List of State codes)
Zip Code: Enter the recipient's zip code, of their permanent address, at the time of follow-up. This is a
required field.
Provider Information (At Time of Follow-up)
Date: Last Seen, Retransplanted or Death: Enter the date the patient was last seen, or the date of
death, or retransplant for this recipient, using the standard 8-digit numeric format of MM/DD/YYYY. If
the recipient died or the graft failed, and you have not completed an interim follow-up indicating these
events, the 6-month follow-up should be completed indicating one of those two events. This is a
required field.
Patient Status: If the recipient is living at the time of follow-up, select Living. If the recipient died
during this follow-up period, select Dead. If the recipient received another kidney from a different donor
during the follow-up period, select Retransplanted. If Dead is selected, indicate the cause of death.
This is a required field. (List of Patient Status codes)
Living
Dead
Retransplanted
Primary Cause of Death: If the Patient Status is Dead, select the patient's cause of death. If
an Other code is selected, enter the other cause of death in the space provided. (List of
Primary Cause of Death codes)
Contributory Cause of Death: If the Patient Status is Dead, select the patient's contributory
cause of death. If an Other code is selected, enter the other cause of death in the space
provided. (List of Contributory Cause of Death codes)
Contributory Cause of Death: If the Patient Status is Dead, select the patient's contributory
cause of death. If an Other code is selected, enter the other cause of death in the space
provided. (List of Contributory Cause of Death codes)
Clinical Information
Graft Status: If the graft is functioning at the time of follow-up, select Functioning. If the graft is not
functioning, select Failed. This is a required field.
Note: If death is indicated for the recipient, and the death was a result of some other factor
unrelated to graft failure, select Functioning.
If Failed is selected, complete the following fields.
Date of Graft Failure: Enter the date of graft failure using the standard 8-digit numeric format
of MM/DD/YYYY.
Primary Cause of Graft Failure: Select the cause of graft failure. (List of Graft Failure codes)
Primary Non-Function
Acute Rejection

Chronic Rejection/Atherosclerosis
Other, Specify
Titer Information: Complete if the recipient received an incompatible blood type donor heart and
death or graft failure is reported within 6 months of transplant:
Most Recent Anti-B Titer: Select the Most Recent Anti-B Titer value, Not taken or Not available
if applicable. Enter the Sample Date in mm/dd/yyyy format. The date to be reported is the date
when the candidate's blood was drawn.
Note: The Sample Date cannot be prior to the recipient's transplant date, cannot be after the graft
failure or the death date and cannot be a future date.
Note: This field will only display if the recipient’s ABO blood-type is A or O.
Most Recent Anti-A Titer: Select the Most Recent Anti-A Titer value, Not taken or Not available
if applicable. Enter the Sample Date in mm/dd/yyyy format. The date to be reported is the date
when the candidate's blood was drawn.
Note: The Sample Date cannot be prior to the recipient's transplant date, cannot be after the graft
failure or the death date and cannot be a future date.
Note: This field will only display if the recipient’s ABO blood-type is B or O.