1 UPDATED -Copy of Copy of Deceased Donor Registration For

			Fields to be completed by members
			Form Section	Field Label	Notes
			1-Donor Information	Donor ID	Display Only - Cascades from feedback
			1-Donor Information	OPO Center Code //OPO	Display Only - Cascades from feedback
			1-Donor Information	OPO Center Type //OPO	Display Only - Cascades from feedback
			1-Donor Information	Donor Hospital Provider Number	Display Only - Cascades from feedback
			1-Donor Information	Donor Hospital Name	Display Only - Cascades from Database
			1-Donor Information	Donor Hospital	Display Only - Cascades from Database
			1-Donor Information	Referral Date
			1-Donor Information	Recovered Outside the U.S.
			1-Donor Information	Country
			1-Donor Information	Last Name
			1-Donor Information	First Name
			1-Donor Information	MI	Not required
			1-Donor Information	DOB
			1-Donor Information	Age
			1-Donor Information	Age Unit
			1-Donor Information	Gender
			1-Donor Information	Home City
			1-Donor Information	State
			1-Donor Information	Zip Code
			1-Donor Information	Ethnicity/Race
			1-Donor Information	Citizenship
			1-Donor Information	Home Country
			1-Donor Information	Cause of Death
			1-Donor Information	Cause of Death //Specify
			1-Donor Information	Mechanism of Death
			1-Donor Information	Circumstances of Death
			2-Procurement and Consent	Medical Examiner/Coroner
			2-Procurement and Consent	Was the patient declared legally brain dead?
			2-Procurement and Consent	Did the patient have written documentation of their intent to be a donor
			2-Procurement and Consent	Driver's license
			2-Procurement and Consent	Donor Card
			2-Procurement and Consent	Donor Registry
			2-Procurement and Consent	Durable Power of Attorney / Healthcare Proxy
			2-Procurement and Consent	Advanced Directive
			2-Procurement and Consent	Other Consent Mechanism //Other Specify
			2-Procurement and Consent	Was the consent based solely on this documentation
			2-Procurement and Consent	Did the patient express to family or others the intent to be a donor
			11-Organ Recovery	Cardiac arrest since neurological event that led to declaration of brain death
			11-Organ Recovery	Duration of Resuscitation //If Yes, Duration of Resuscitation
			11-Organ Recovery	Duration of Resuscitation //Status	Value or status is reported, not both
			2-Procurement and Consent	Date and time of pronouncement of death: (Complete for brain dead and DCD donors)
			2-Procurement and Consent	Date and time consent obtained for organ donation
			3-Clinical Information	ABO Blood Group	Display Only - Cascades from feedback
			3-Clinical Information	Height in Ft//Height	Display Only - Cascades from Database
			3-Clinical Information	Height in In//Height	Display Only - Cascades from Database
			3-Clinical Information	Height in cm
			3-Clinical Information	Height in cm //Status	Value or status is reported, not both
			3-Clinical Information	Weight in Lbs//Weight	Display Only - Cascades from Database
			3-Clinical Information	Weight in kg
			3-Clinical Information	Weight in kg //Status	Value or status is reported, not both
			4-Terminal Lab Data	Protein in Urine
			4-Terminal Lab Data	Serum Sodium
			4-Terminal Lab Data	Serum Sodium Status //Status	Value or status is reported, not both
			4-Terminal Lab Data	BUN
			4-Terminal Lab Data	BUN //Status	Value or status is reported, not both
			4-Terminal Lab Data	Serum Creatinine
			4-Terminal Lab Data	Serum Creatinine //Status	Value or status is reported, not both
			4-Terminal Lab Data	Total Bilirubin
			4-Terminal Lab Data	Total Bilirubin //Status	Value or status is reported, not both
			4-Terminal Lab Data	SGOT/AST
			4-Terminal Lab Data	SGOT/AST Status //Status	Value or status is reported, not both
			4-Terminal Lab Data	SGPT/ALT
			4-Terminal Lab Data	SGPT/ALT //Status	Value or status is reported, not both
			4-Terminal Lab Data	INR
			4-Terminal Lab Data	INR //Status	Value or status is reported, not both
			4-Terminal Lab Data	Hematocrit
			4-Terminal Lab Data	Hematocrit //Status	Value or status is reported, not both
			4-Terminal Lab Data	Serum Amylase
			4-Terminal Lab Data	Serum Amylase //Status	Value or status is reported, not both
			4-Terminal Lab Data	Serum Lipase
			4-Terminal Lab Data	Serum Lipase //Status	Value or status is reported, not both
			4-Terminal Lab Data	HbA1c
			4-Terminal Lab Data	HbA1c//Status	Value or status is reported, not both
			5-Serology	HIV Serology Results
			5-Serology	HIV Antigen/Antibody
			5-Serology	HTLV Serology Results
			5-Serology	RPR-VDRL
			5-Serology	Anti-CMV
			5-Serology	HBsAg Serology Results
			5-Serology	Anti-HBc Serology Results
			5-Serology	Anti-HCV Serology Results
			5-Serology	HBsAb
			5-Serology	EBV (VCA) (lgG)
			5-Serology	EBV (VCA) (lgM)
			5-Serology	EBNA
			5-Serology	Chagas Serology Results
			5-Serology	West Nile Serology Results
			5-Serology	Toxoplasma (IgG) Serology Results
			NAT Results:	HIV NAT Results
			NAT Results:	HBV DNA Results
			NAT Results:	HCV NAT Results
			NAT Results:	HTLV NAT Results
			NAT Results:	Chagas NAT Results
			NAT Results:	West Nile NAT Results
			6-Donor Management	Steroids
			6-Donor Management	Diuretics
			6-Donor Management	T3
			6-Donor Management	T4
			6-Donor Management	Antihypertensives
			6-Donor Management	Vasodilators
			6-Donor Management	DDAVP
			6-Donor Management	Heparin
			6-Donor Management	Arginine Vasopressin
			6-Donor Management	Insulin
			6-Donor Management	Donor management other medication, specify	Not required
			6-Donor Management	Donor management other medication, specify (2)	Not required
			6-Donor Management	Donor management other medication, specify (3)	Not required
			6-Donor Management	Inotropic Medications at Time of Cross Clamp
			6-Donor Management	Medication
			6-Donor Management	Medication //Specify
			6-Donor Management	Medication
			6-Donor Management	Medication //Specify
			6-Donor Management	Medication
			6-Donor Management	Medication //Specify
			6-Donor Management	Number of transfusions during this (terminal) hospitalization
			8-Clinical Infection	Clinical Infection Confirmed by Culture
			8-Clinical Infection	Source
			8-Clinical Infection	Blood
			8-Clinical Infection	Lung
			8-Clinical Infection	Urine
			8-Clinical Infection	Other
			8-Clinical Infection	Other, specify
			10-Donor History	Cigarette Use (> 20 pack years) - Ever
			10-Donor History	Cigarette Use //AND continued in last six months
			10-Donor History	Cocaine Use - Ever
			10-Donor History	Cocaine Use //AND continued in last six months
			10-Donor History	Other Drug Use (non - IV) - Ever
			10-Donor History	Other Drug Use //AND continued in last six months
			10-Donor History	Heavy Alcohol Use (heavy= 2+ drinks/day)
			10-Donor History	Tattoos
			10-Donor History	According to the OPTN policy in effect on the date of referral, does the donor have risk factors for blood-borne disease transmission
			10-Donor History	History of Diabetes
			10-Donor History	Insulin Dependent
			10-Donor History	History of Hypertension
			10-Donor History	Diet
			10-Donor History	Diuretics
			10-Donor History	Other anti-hypertensive medication
			10-Donor History	History of Cancer
			10-Donor History	History of Cancer //Specify
			10-Donor History	Cancer Free Interval
			10-Donor History	Cancer Free Interval //Status	Value or status is reported, not both
			10-Donor History	Intracranial
			10-Donor History	Type (Intracranial):
			10-Donor History	Other Type/ Specify
			10-Donor History	Extracranial
			10-Donor History	Type (for Extracranial):
			10-Donor History	Other Type/ Specify
			10-Donor History	Skin
			10-Donor History	Type (for Skin):
			10-Donor History	Other Type/ Specify
			10-Donor History	Chagas History
			10-Donor History	TB History
			11-Organ Recovery	Recovery Date (donor to OR)
			11-Organ Recovery	Was this donor recovered under DCD protocol
			11-Organ Recovery	If Yes, Controlled
			11-Organ Recovery	If Yes, Date and time of withdrawal of support
			11-Organ Recovery	If Yes, Date and time agonal phase begins (systolic BP < 80 or O2 sat. < 80%)
			11-Organ Recovery	If DCD, Total urine output during OR recovery phase
			11-Organ Recovery	DCD Measures//Date and time of measures
			11-Organ Recovery	DCD Measures//Systolic blood pressure
			11-Organ Recovery	DCD Measures//Systolic blood pressure//Status	Value or status is reported, not both
			11-Organ Recovery	DCD Measures//Diastolic blood pressure
			11-Organ Recovery	DCD Measures//Diastolic blood pressure//Status	Value or status is reported, not both
			11-Organ Recovery	DCD Measures//Mean arterial pressure
			11-Organ Recovery	DCD Measures//Mean arterial pressure//Status	Value or status is reported, not both
			11-Organ Recovery	DCD Measures//O2 saturation
			11-Organ Recovery	DCD Measures//O2 saturation//Status	Value or status is reported, not both
			11-Organ Recovery	If Yes, Core Cooling Used
			11-Organ Recovery	If yes, Date and time of abdominal aorta core cooling
			11-Organ Recovery	Date and time of abdominal aorta core cooling://Status	Value or status is reported, not both
			11-Organ Recovery	If yes, Date and time of thoracic aorta core cooling
			11-Organ Recovery	Date and time of thoracic aorta core cooling://Status	Value or status is reported, not both
			11-Organ Recovery	If yes, Date and time of portal vein core cooling
			11-Organ Recovery	Date and time of portal vein core cooling://Status	Value or status is reported, not both
			11-Organ Recovery	If yes, Date and time of pulmonary artery core cooling
			11-Organ Recovery	Date and time of pulmonary artery core cooling://Status	Value or status is reported, not both
			11-Organ Recovery	If No, Was this a consented DCD donor that progressed to brain death?
			11-Organ Recovery	Clamp Date
			11-Organ Recovery	Clamp Time: (Military Time)
			11-Organ Recovery	Clamp Time //Status	Value or status is reported, not both
			11-Organ Recovery	Clamp Time Zone
			11-Organ Recovery	History of previous MI
			11-Organ Recovery	LV ejection fraction (%)
			11-Organ Recovery	LV Ejection Fraction % //Status	Value or status is reported, not both
			11-Organ Recovery	Method
			11-Organ Recovery	Structural Abnormalities //Valves
			11-Organ Recovery	Structural Abnormalities //Congenital
			11-Organ Recovery	Structural Abnormalities //LVH
			11-Organ Recovery	Wall Abnormalities //Segmental
			11-Organ Recovery	Wall Abnormalities //Global
			11-Organ Recovery	Heart machine perfusion
			11-Organ Recovery	Coronary Angiogram
			11-Organ Recovery	If Abnormal, # of Vessels with > 50% Stenosis
			11-Organ Recovery	ABG Results	Display Only
			4-Terminal Lab Data	Blood pH
			4-Terminal Lab Data	PH //Status	Value or status is reported, not both
			11-Organ Recovery	PCO<sub>2
			11-Organ Recovery	PCO2 //Status	Value or status is reported, not both
			11-Organ Recovery	PO2
			11-Organ Recovery	PO2//Status	Value or status is reported, not both
			11-Organ Recovery	FiO2
			11-Organ Recovery	FiO2//Status	Value or status is reported, not both
			11-Organ Recovery	PEEP
			11-Organ Recovery	PEEP//Status	Value or status is reported, not both
			11-Organ Recovery	Ventilator Mode
			11-Organ Recovery	Ventilator Mode//Other Specify
			11-Organ Recovery	Was a pulmonary artery catheter placed
			11-Organ Recovery	MAP (initial) // MAP: (mm Hg)
			11-Organ Recovery	MAP (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	MAP (final) // MAP: (mm Hg)
			11-Organ Recovery	MAP (final) //Status	Value or status is reported, not both
			11-Organ Recovery	CVP (initial) // CVP: (mm Hg)
			11-Organ Recovery	CVP (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	CVP (final) // CVP: (mm Hg)
			11-Organ Recovery	CVP (final) //Status	Value or status is reported, not both
			11-Organ Recovery	PCWP (initial) // PCWP: (mm Hg)
			11-Organ Recovery	PCWP (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	PCWP (final) // PCWP: (mm Hg)
			11-Organ Recovery	PCWP (final) //Status	Value or status is reported, not both
			11-Organ Recovery	SVR (initial) //SVR: ((dynes/sec/cm)^5)
			11-Organ Recovery	SVR (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	SVR (final) //SVR
			11-Organ Recovery	SVR (final) //Status	Value or status is reported, not both
			11-Organ Recovery	PA Systolic (initial) // PA Systolic: (mm Hg)
			11-Organ Recovery	PA Systolic (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	PA Systolic (final) // PA Systolic: (mm Hg)
			11-Organ Recovery	PA Systolic (final) //Status	Value or status is reported, not both
			11-Organ Recovery	PA Diastolic (initial) // PA Diastolic: (mm Hg)
			11-Organ Recovery	PA Diastolic (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	PA Diastolic (final) // PA Diastolic: (mm Hg)
			11-Organ Recovery	PA Diastolic (final) //Status	Value or status is reported, not both
			11-Organ Recovery	CO (initial) (L/min) //CO: (L/min)
			11-Organ Recovery	CO (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	CO (final) (L/min) //CO
			11-Organ Recovery	CO (final) //Status	Value or status is reported, not both
			11-Organ Recovery	Cardiac Index (initial) //Cardiac Index: (L/min/sq.m)
			11-Organ Recovery	Cardiac Index (initial) //Status	Value or status is reported, not both
			11-Organ Recovery	Cardiac Index (final) //Cardiac Index
			11-Organ Recovery	Cardiac Index (final) //Status	Value or status is reported, not both
			11-Organ Recovery	Biopsy (heart donors only)
			11-Organ Recovery	Other Diagnosis /Specify
			11-Organ Recovery	Any Extracorporeal Support Given
			11-Organ Recovery	How long:
			11-Organ Recovery	How long://Status	Value or status is reported, not both
			11-Organ Recovery	Flow Rate
			11-Organ Recovery	Flow Rate//Status	Value or status is reported, not both
			11-Organ Recovery	Left Kidney Biopsy
			11-Organ Recovery	Type of Biopsy
			11-Organ Recovery	Type of Biopsy//Specify
			11-Organ Recovery	Interstitial Fibrosis
			11-Organ Recovery	Vascular Changes
			11-Organ Recovery	Number of Glomeruli Visualized
			11-Organ Recovery	% Glomerulosclerosis (Left Kidney) //Glomerulosclerosis
			11-Organ Recovery	Pump (Left Kidney) //Pump
			11-Organ Recovery	Final Resistance Prior to Shipping (left) //Final Resistance Prior to Shipping
			11-Organ Recovery	Final Resistance Prior to Shipping (left) //Status	Value or status is reported, not both
			11-Organ Recovery	Transferred on pump (left):// Transferred to transplant center on pump
			11-Organ Recovery	Type of Left Kidney Pump/Machine
			11-Organ Recovery	Type of Left Kidney Pump/Machine//Specify
			11-Organ Recovery	Kidney Biopsy (right)://Right Kidney Biopsy
			11-Organ Recovery	Type of Biopsy
			11-Organ Recovery	Type of Biopsy//Specify
			11-Organ Recovery	Interstitial Fibrosis
			11-Organ Recovery	Vascular Changes
			11-Organ Recovery	Number of Glomeruli Visualized
			11-Organ Recovery	% Glomerulosclerosis (Right Kidney)://Glomerulosclerosis
			11-Organ Recovery	Pump (Right Kidney) //Pump
			11-Organ Recovery	Final Resistance Prior to Shipping (right) //Final Resistance Prior to Shipping
			11-Organ Recovery	Final Resistance Prior to Shipping (right) //Status	Value or status is reported, not both
			11-Organ Recovery	Transferred on pump (right):// Transferred to transplant center on pump
			11-Organ Recovery	Type of Right Kidney Pump/Machine
			11-Organ Recovery	Type of Right Kidney Pump/Machine//Specify
			11-Organ Recovery	Liver Biopsy
			11-Organ Recovery	Type of Liver Biopsy
			11-Organ Recovery	Type of Liver Biopsy//Specify
			11-Organ Recovery	Fibrosis
			11-Organ Recovery	Portal Infilitrates
			11-Organ Recovery	% Macro vesicular fat
			11-Organ Recovery	% Macro vesicular fat //Status	Value or status is reported, not both
			11-Organ Recovery	% Micro/intermediate vesicular fat
			11-Organ Recovery	% Micro/intermediate vesicular fat //Status	Value or status is reported, not both
			11-Organ Recovery	Liver Machine Perfusion
			11-Organ Recovery	Type of Liver Machine Perfusion
			11-Organ Recovery	Type of Liver Machine Perfusion//Specify
			11-Organ Recovery	Left Lung Bronchoscopy
			11-Organ Recovery	Left Lung Machine Perfusion
			11-Organ Recovery	Right Lung Bronchoscopy
			11-Organ Recovery	Right Lung Machine Perfusion
			11-Organ Recovery	Chest X-ray
			15-Organ Dispostion	Disposition of Organ - Right Kidney://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time right kidney recovered/removed from donor
			15-Organ Disposition	Recipient: RKI	Display Only - Cascades from Database
			15-Organ Disposition	SSN: RKI	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: RKI	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Right Kidney://Reason Code
			15-Organ Dispostion	Reason Code Right Kidney //Specify
			15-Organ Dispostion	Reason organ not transplanted - Right Kidney://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Right Kidney //Specify
			15-Organ Dispostion	Recovery Team# - Right Kidney://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Right Kidney://Initial Flush Solution
			15-Organ Dispostion	Initial Flush - Right Kidney //Specify
			15-Organ Dispostion	Back Table Flush Solution - Right Kidney://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Right Kidney //Specify
			15-Organ Dispostion	chest X-ray
			15-Organ Dispostion	Final Flush Right Kidney //Specify
			15-Organ Dispostion	OPO sent vessels with organ: RKI	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: RKI	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: RKI	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Left Kidney://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time left kidney recovered/removed from donor
			15-Organ Disposition	Recipient: LKI	Display Only - Cascades from Database
			15-Organ Disposition	SSN: LKI	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: LKI	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Left Kidney://Reason Code
			15-Organ Dispostion	Reason Code Left Kidney //Specify
			15-Organ Dispostion	Reason organ not transplanted - Left Kidney://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Left Kidney //Specify
			15-Organ Dispostion	Recovery Team# - Left Kidney://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Left Kidney://Initial Flush Solution
			15-Organ Dispostion	Initial Flush - Left Kidney //Specify
			15-Organ Dispostion	Back Table Flush Solution - Left Kidney://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Left Kidney //Specify
			15-Organ Dispostion	Final Flush Solution - Left Kidney://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Left Kidney //Specify
			15-Organ Dispostion	OPO sent vessels with organ: LKI	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: LKI	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: LKI	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Double/En-bloc Kidney://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time double/en-bloc kidney recovered/removed from donor
			15-Organ Disposition	Recipient: EKI	Display Only - Cascades from Database
			15-Organ Disposition	SSN: EKI	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: EKI	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Double/En-bloc Kidney://Reason Code
			15-Organ Dispostion	Reason Code - Double/En-bloc Kidney //Specify
			15-Organ Dispostion	Reason organ not transplanted -Double/En-bloc Kidney://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted - Double/En-bloc Kidney //Specify
			15-Organ Dispostion	Recovery Team# - Double/En-bloc Kidney://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Double/En-bloc Kidney://Initial Flush Solution
			15-Organ Dispostion	Initial Flush - Double/En-bloc Kidney //Specify
			15-Organ Dispostion	Back Table Flush Solution - Double/En-bloc Kidney://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Double/En-bloc Kidney //Specify
			15-Organ Dispostion	Final Flush Solution - Double/En-bloc Kidney://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Double/En-bloc Kidney //Specify
			15-Organ Dispostion	OPO sent vessels with organ: EKI	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: EKI	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: EKI	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Pancreas://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time whole pancreas recovered/removed from donor
			15-Organ Disposition	Recipient: PA	Display Only - Cascades from Database
			15-Organ Disposition	SSN: PA	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: PA	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Pancreas://Reason Code
			15-Organ Dispostion	Reason Code - Pancreas //Specify
			15-Organ Dispostion	Reason organ not transplanted -Pancreas://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Pancreas //Specify
			15-Organ Dispostion	Recovery Team# - Pancreas://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Pancreas://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Pancreas //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Back Table Flush Solution - Pancreas://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Pancreas //Specify
			15-Organ Dispostion	Back Table Flush Solution Volume
			15-Organ Dispostion	Back Table Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Final Flush Solution - Pancreas://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Pancreas //Specify
			15-Organ Dispostion	OPO sent vessels with organ: PA	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: PA	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: PA	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Pancreas Segment 1://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date, and time pancreas segment 1 recovered/removed from donor
			15-Organ Disposition	Recipient: PAS1	Display Only - Cascades from Database
			15-Organ Disposition	SSN: PAS1	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: PAS1	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Pancreas Segment 1://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Pancreas Segment 1 //Specify
			15-Organ Dispostion	Reason organ not transplanted -Pancreas Segment 1://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Pancreas Segment 1 //Specify
			15-Organ Dispostion	Recovery Team# - Pancreas Segment 1://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Pancreas Segment 1://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Pancreas Segment 1 //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Back Table Flush Solution - Pancreas Segment 1://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Pancreas Segment 1 //Specify
			15-Organ Dispostion	Back Table Flush Solution Volume
			15-Organ Dispostion	Back Table Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Final Flush Solution - Pancreas Segment 1://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Pancreas Segment 1 //Specify
			15-Organ Dispostion	OPO sent vessels with organ: PAS1	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: PAS1	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: PAS1	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Pancreas Segment 2://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time pancreas segment 2 recovered/removed from donor
			15-Organ Disposition	Recipient: PAS2	Display Only - Cascades from Database
			15-Organ Disposition	SSN: PAS2	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: PAS2	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Pancreas Segment 2://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Pancreas Segment 2 //Specify
			15-Organ Dispostion	Reason organ not transplanted -Pancreas Segment 2://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Pancreas Segment 2 //Specify
			15-Organ Dispostion	Recovery Team# - Pancreas Segment 2://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Pancreas Segment 2://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Pancreas Segment 2 //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Back Table Flush Solution - Pancreas Segment 2://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Pancreas Segment 2 //Specify
			15-Organ Dispostion	Back Table Flush Solution Volume
			15-Organ Dispostion	Back Table Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Final Flush Solution - Pancreas Segment 2://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Pancreas Segment 2 //Specify
			15-Organ Dispostion	OPO sent vessels with organ: PAS2	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: PAS2	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: PAS2	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Liver://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time whole liver recovered/removed from donor
			15-Organ Disposition	Recipient: LI	Display Only - Cascades from Database
			15-Organ Disposition	SSN: LI	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: LI	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Liver://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Liver //Specify
			15-Organ Dispostion	Reason organ not transplanted -Liver://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Liver //Specify
			15-Organ Dispostion	Recovery Team# - Liver://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Liver://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Liver //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Back Table Flush Solution - Liver://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Liver //Specify
			15-Organ Dispostion	Back Table Flush Solution Volume
			15-Organ Dispostion	Back Table Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Final Flush Solution - Liver://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Liver //Specify
			15-Organ Dispostion	OPO sent vessels with organ: LI	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: LI	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: LI	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Liver Segment 1://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time liver segment 1 recovered/removed from donor
			15-Organ Disposition	Recipient: LIS1	Display Only - Cascades from Database
			15-Organ Disposition	SSN: LIS1	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: LIS1	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Liver Segment 1://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Liver Segment 1 //Specify
			15-Organ Dispostion	Reason organ not transplanted -Liver Segment 1://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Liver Segment 1 //Specify
			15-Organ Dispostion	Recovery Team# - Liver Segment 1://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Liver Segment 1://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Liver Segment 1 //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Back Table Flush Solution - Liver Segment 1://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Liver Segment 1 //Specify
			15-Organ Dispostion	Back Table Flush Solution Volume
			15-Organ Dispostion	Back Table Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Final Flush Solution - Liver Segment 1://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Liver Segment 1 //Specify
			15-Organ Dispostion	OPO sent vessels with organ: LIS1	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: LIS1	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: LIS1	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Liver Segment 2://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time liver segment 2 recovered/removed from donor
			15-Organ Disposition	Recipient: LIS2	Display Only - Cascades from Database
			15-Organ Disposition	SSN: LIS2	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: LIS2	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Liver Segment 2://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Liver Segment 2 //Specify
			15-Organ Dispostion	Reason organ not transplanted -Liver Segment 2://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Liver Segment 2 //Specify
			15-Organ Dispostion	Recovery Team# - Liver Segment 2://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Liver Segment 2://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Liver Segment 2 //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Back Table Flush Solution - Liver Segment 2://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Liver Segment 2 //Specify
			15-Organ Dispostion	Initial Flush Solution Volume
			15-Organ Dispostion	Initial Flush Solution Volume//Status	Value or status is reported, not both
			15-Organ Dispostion	Final Flush Solution - Liver Segment 2://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Liver Segment 2 //Specify
			15-Organ Dispostion	OPO sent vessels with organ: LIS2	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: LIS2	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: LIS2	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Intestine://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time whole intestine recovered/removed from donor
			15-Organ Disposition	Recipient: IN	Display Only - Cascades from Database
			15-Organ Disposition	SSN: IN	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: IN	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Intestine://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Intestine //Specify
			15-Organ Dispostion	Reason organ not transplanted -Intestine ://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Intestine //Specify
			15-Organ Dispostion	Recovery Team# - Intestine://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Intestine://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Intestine //Specify
			15-Organ Dispostion	Back Table Flush Solution - Intestine://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Intestine //Specify
			15-Organ Dispostion	Final Flush Solution - Intestine://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Intestine //Specify
			15-Organ Dispostion	OPO sent vessels with organ: IN	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: IN	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: IN	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Intestine Segment 1://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time intestine segment 1 recovered/removed from donor
			15-Organ Disposition	Recipient: INS1	Display Only - Cascades from Database
			15-Organ Disposition	SSN: INS1	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: INS1	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Intestine Segment 1://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Intestine Segment 1 //Specify
			15-Organ Dispostion	Reason organ not transplanted -Intestine Segment 1://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Intestine Segment 1 //Specify
			15-Organ Dispostion	Recovery Team# - Intestine Segment 1://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Intestine Segment 1://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Intestine Segment 1 //Specify
			15-Organ Dispostion	Back Table Flush Solution - Intestine Segment 1://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Intestine Segment 1 //Specify
			15-Organ Dispostion	Final Flush Solution - Intestine Segment 1://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Intestine Segment 1 //Specify
			15-Organ Dispostion	OPO sent vessels with organ: INS1	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: INS1	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: INS1	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Intestine Segment 2://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time intestine segment 2 recovered/removed from donor
			15-Organ Disposition	Recipient: INS2	Display Only - Cascades from Database
			15-Organ Disposition	SSN: INS2	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: INS2	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Intestine Segment 2://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Intestine Segment 2 //Specify
			15-Organ Dispostion	Reason organ not transplanted -Intestine Segment 2://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Intestine Segment 2 //Specify
			15-Organ Dispostion	Recovery Team# - Intestine Segment 2://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Intestine Segment 2://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Intestine Segment 2 //Specify
			15-Organ Dispostion	Back Table Flush Solution - Intestine Segment 2://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Intestine Segment 2 //Specify
			15-Organ Dispostion	Final Flush Solution - Intestine Segment 2://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Intestine Segment 2 //Specify
			15-Organ Dispostion	OPO sent vessels with organ: INS2	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: INS2	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: INS2	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Heart://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time heart recovered/removed from donor
			15-Organ Disposition	Recipient: HR	Display Only - Cascades from Database
			15-Organ Disposition	SSN: HR	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: HR	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Heart://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Heart //Specify
			15-Organ Dispostion	Reason organ not transplanted -Heart://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Heart //Specify
			15-Organ Dispostion	Recovery Team# - Heart://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Heart://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Heart //Specify
			15-Organ Dispostion	Back Table Flush Solution - Heart://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Heart //Specify
			15-Organ Dispostion	Final Flush Solution - Heart://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Heart //Specify
			15-Organ Dispostion	OPO sent vessels with organ: HR	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: HR	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: HR	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Right Lung://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time left lung recovered/removed from donor
			15-Organ Disposition	Recipient: LUL	Display Only - Cascades from Database
			15-Organ Disposition	SSN: LUL	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: LUL	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Right Lung://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Right Lung //Specify
			15-Organ Dispostion	Reason organ not transplanted -Right Lung://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Right Lung //Specify
			15-Organ Dispostion	Recovery Team# - Right Lung://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Right Lung://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Right Lung //Specify
			15-Organ Dispostion	Back Table Flush Solution - Right Lung://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Right Lung //Specify
			15-Organ Dispostion	Final Flush Solution - Right Lung://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Right Lung //Specify
			15-Organ Dispostion	OPO sent vessels with organ: LUL	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: LUL	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: LUL	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Left Lung://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time right lung recovered/removed from donor
			15-Organ Disposition	Recipient: LUR	Display Only - Cascades from Database
			15-Organ Disposition	SSN: LUR	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: LUR	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Left Lung://Reason Code
			15-Organ Dispostion	Reason Code/Specify - Left Lung //Specify
			15-Organ Dispostion	Reason organ not transplanted -Left Lung://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Left Lung //Specify
			15-Organ Dispostion	Recovery Team# - Left Lung://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Left Lung://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Left Lung //Specify
			15-Organ Dispostion	Back Table Flush Solution - Left Lung://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Left Lung //Specify
			15-Organ Dispostion	Final Flush Solution - Left Lung://Final Flush/Storage Solution
			15-Organ Dispostion	Final Flush Solution Specify - Left Lung //Specify
			15-Organ Dispostion	OPO sent vessels with organ: LUR	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: LUR	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: LUR	Display Only - Cascades from Database
			15-Organ Dispostion	Disposition of Organ - Double/En-bloc Lung://Organ	Display Only - Cascades from feedback
			15-Organ Disposition	If DCD, date and time double/en-bloc lung recovered/removed from donor
			15-Organ Disposition	Recipient: DLU	Display Only - Cascades from Database
			15-Organ Disposition	SSN: DLU	Display Only - Cascades from Database
			15-Organ Disposition	TX Center: DLU	Display Only - Cascades from Database
			15-Organ Dispostion	Reason Code - Double/En-bloc Lung://Reason Code
			15-Organ Dispostion	Reason Code/Specify - DoubleEn-bloc Lung //Specify
			15-Organ Dispostion	Reason organ not transplanted -Double/En-bloc Lung://Reason organ not transplanted
			15-Organ Dispostion	Reason organ not transplanted Other Specify - Double/En-bloc Lung //Specify
			15-Organ Dispostion	Recovery Team# - Double/En-bloc Lung://Recovery Team#
			15-Organ Dispostion	Initial Flush Solution - Double/En-bloc Lung://Initial Flush Solution
			15-Organ Dispostion	Initial Flush Other Specify - Double/En-bloc Lung //Specify
			15-Organ Dispostion	Back Table Flush Solution - Double/En-bloc Lung://Back Table Flush Solution
			15-Organ Dispostion	Back Table Flush Solution Specify - Double/En-bloc Lung //Specify
			15-Organ Dispostion	Final Flush Solution Specify - Double/En-bloc Lung //Specify
			15-Organ Dispostion	Final Flush Solution - Double/En-bloc Lung://Final Flush/Storage Solution
			15-Organ Dispostion	OPO sent vessels with organ: DLU	Display Only - Cascades from Database
			15-Organ Dispostion	Were extra vessels used in the transplant procedure: DLU	Display Only - Cascades from Database
			15-Organ Dispostion	Vessel Donor ID: DLU	Display Only - Cascades from Database
				Public Burden Statement