1 Deceased Donor Registration Form.CLEAN.xlsx
Data System for Organ Procurement and Transplantation Network
05.12.2020 Deceased Donor Registration Form.CLEAN.xlsx .xlsx
Deceased Donor Registration (DDR)
OMB: 0915-0157
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0915-0157 can be found here:
Document [xlsx]
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| Fields to be completed by members | |||||||
| Form Section | Field Label | Notes | |||||
| Donor Information | Donor ID | Display Only - Cascades from feedback | |||||
| Donor Information | OPO Center Code //OPO | Display Only - Cascades from feedback | |||||
| Donor Information | OPO Center Type //OPO | Display Only - Cascades from feedback | |||||
| Donor Information | Donor Hospital Provider Number | Display Only - Cascades from feedback | |||||
| Donor Information | Donor Hospital Name | Display Only - Cascades from Database | |||||
| Donor Information | Donor Hospital | Display Only - Cascades from Database | |||||
| Donor Information | Referral Date | ||||||
| Donor Information | Recovered Outside the U.S. | ||||||
| Donor Information | Country | ||||||
| Donor Information | Last Name | ||||||
| Donor Information | First Name | ||||||
| Donor Information | MI | Not required | |||||
| Donor Information | DOB | ||||||
| Donor Information | Age | ||||||
| Donor Information | Age Unit | ||||||
| Donor Information | Gender | ||||||
| Donor Information | Home City | ||||||
| Donor Information | State | ||||||
| Donor Information | Zip Code | ||||||
| Donor Information | Ethnicity/Race | ||||||
| Donor Information | Citizenship | ||||||
| Donor Information | Home Country | ||||||
| Donor Information | Cause of Death | ||||||
| Donor Information | Cause of Death //Specify | ||||||
| Donor Information | Mechanism of Death | ||||||
| Donor Information | Circumstances of Death | ||||||
| Procurement and Authorization | Medical Examiner/Coroner | ||||||
| Procurement and Authorization | Was the patient declared legally brain dead? | ||||||
| Procurement and Authorization | Did the patient have written documentation of their intent to be a donor | ||||||
| Procurement and Authorization | Driver's license | ||||||
| Procurement and Authorization | Donor Card | ||||||
| Procurement and Authorization | Donor Registry | ||||||
| Procurement and Authorization | Durable Power of Attorney / Healthcare Proxy | ||||||
| Procurement and Authorization | Advanced Directive | ||||||
| Procurement and Authorization | Other Consent Mechanism //Other Specify | ||||||
| Procurement and Authorization | Was the consent based solely on this documentation | ||||||
| Procurement and Authorization | Did the patient express to family or others the intent to be a donor | ||||||
| Procurement and Authorization | Cardiac arrest since neurological event that led to declaration of brain death | ||||||
| Procurement and Authorization | Duration of Resuscitation //If Yes, Duration of Resuscitation | ||||||
| Procurement and Authorization | Duration of Resuscitation //Status | Value or status is reported, not both | |||||
| Procurement and Authorization | Date and time of pronouncement of death: (Complete for brain dead and DCD donors) | ||||||
| Procurement and Authorization | Date and time consent obtained for organ donation | ||||||
| Clinical Information | ABO Blood Group | Display Only - Cascades from feedback | |||||
| Clinical Information | Height in Ft//Height | Display Only - Cascades from Database | |||||
| Clinical Information | Height in In//Height | Display Only - Cascades from Database | |||||
| Clinical Information | Height in cm | ||||||
| Clinical Information | Height in cm //Status | Value or status is reported, not both | |||||
| Clinical Information | Weight in Lbs//Weight | Display Only - Cascades from Database | |||||
| Clinical Information | Weight in kg | ||||||
| Clinical Information | Weight in kg //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | Protein in Urine | ||||||
| Terminal Lab Data | Serum Sodium | ||||||
| Terminal Lab Data | Serum Sodium Status //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | BUN | ||||||
| Terminal Lab Data | BUN //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | Serum Creatinine | ||||||
| Terminal Lab Data | Serum Creatinine //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | Total Bilirubin | ||||||
| Terminal Lab Data | Total Bilirubin //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | SGOT/AST | ||||||
| Terminal Lab Data | SGOT/AST Status //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | SGPT/ALT | ||||||
| Terminal Lab Data | SGPT/ALT //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | INR | ||||||
| Terminal Lab Data | INR //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | Hematocrit | ||||||
| Terminal Lab Data | Hematocrit //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | Serum Amylase | ||||||
| Terminal Lab Data | Serum Amylase //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | Serum Lipase | ||||||
| Terminal Lab Data | Serum Lipase //Status | Value or status is reported, not both | |||||
| Terminal Lab Data | HbA1c | ||||||
| Terminal Lab Data | HbA1c//Status | Value or status is reported, not both | |||||
| Serology | HIV Serology Results | ||||||
| Serology | HIV Antigen/Antibody | ||||||
| Serology | HTLV Serology Results | ||||||
| Serology | RPR-VDRL | ||||||
| Serology | Anti-CMV | ||||||
| Serology | HBsAg Serology Results | ||||||
| Serology | Anti-HBc Serology Results | ||||||
| Serology | Anti-HCV Serology Results | ||||||
| Serology | HBsAb | ||||||
| Serology | EBV (VCA) (lgG) | ||||||
| Serology | EBV (VCA) (lgM) | ||||||
| Serology | EBNA | ||||||
| Serology | Chagas Serology Results | ||||||
| Serology | West Nile Serology Results | ||||||
| Serology | Toxoplasma (IgG) Results | ||||||
| Serology | Strongyloides 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 | ||||||
| Donor Management | Steroids | ||||||
| Donor Management | Diuretics | ||||||
| Donor Management | T3 | ||||||
| Donor Management | T4 | ||||||
| Donor Management | Antihypertensives | ||||||
| Donor Management | Vasodilators | ||||||
| Donor Management | DDAVP | ||||||
| Donor Management | Heparin | ||||||
| Donor Management | Arginine Vasopressin | ||||||
| Donor Management | Insulin | ||||||
| Donor Management | Donor management other medication, specify | Not required | |||||
| Donor Management | Donor management other medication, specify (2) | Not required | |||||
| Donor Management | Donor management other medication, specify (3) | Not required | |||||
| Donor Management | Inotropic Medications at Time of Cross Clamp | ||||||
| Donor Management | Medication | ||||||
| Donor Management | Medication //Specify | ||||||
| Donor Management | Medication | ||||||
| Donor Management | Medication //Specify | ||||||
| Donor Management | Medication | ||||||
| Donor Management | Medication //Specify | ||||||
| Donor Management | Number of transfusions during this (terminal) hospitalization | ||||||
| Clinical Infection | Clinical Infection Confirmed by Culture | ||||||
| Clinical Infection | Source | ||||||
| Clinical Infection | Blood | ||||||
| Clinical Infection | Lung | ||||||
| Clinical Infection | Urine | ||||||
| Clinical Infection | Other | ||||||
| Clinical Infection | Other, specify | ||||||
| Lifestyle Factors | Cigarette Use (> 20 pack years) - Ever | ||||||
| Lifestyle Factors | Cigarette Use //AND continued in last six months | ||||||
| Lifestyle Factors | Cocaine Use - Ever | ||||||
| Lifestyle Factors | Cocaine Use //AND continued in last six months | ||||||
| Lifestyle Factors | Other Drug Use (non - IV) - Ever | ||||||
| Lifestyle Factors | Other Drug Use //AND continued in last six months | ||||||
| Lifestyle Factors | Heavy Alcohol Use (heavy= 2+ drinks/day) | ||||||
| Lifestyle Factors | Tattoos | ||||||
| Lifestyle Factors | According to the OPTN policy in effect on the date of referral, does the donor have risk factors for blood-borne disease transmission | ||||||
| Lifestyle Factors | History of Diabetes | ||||||
| Lifestyle Factors | Insulin Dependent | ||||||
| Lifestyle Factors | History of Hypertension | ||||||
| Lifestyle Factors | Diet | ||||||
| Lifestyle Factors | Diuretics | ||||||
| Lifestyle Factors | Other anti-hypertensive medication | ||||||
| Lifestyle Factors | History of Cancer | ||||||
| Lifestyle Factors | History of Cancer //Specify | ||||||
| Lifestyle Factors | Cancer Free Interval | ||||||
| Lifestyle Factors | Cancer Free Interval //Status | Value or status is reported, not both | |||||
| Lifestyle Factors | Intracranial | ||||||
| Lifestyle Factors | Type (Intracranial): | ||||||
| Lifestyle Factors | Other Type/ Specify | ||||||
| Lifestyle Factors | Extracranial | ||||||
| Lifestyle Factors | Type (for Extracranial): | ||||||
| Lifestyle Factors | Other Type/ Specify | ||||||
| Lifestyle Factors | Skin | ||||||
| Lifestyle Factors | Type (for Skin): | ||||||
| Lifestyle Factors | Other Type/ Specify | ||||||
| Lifestyle Factors | Chagas History | ||||||
| Lifestyle Factors | TB History | ||||||
| Organ Recovery | Recovery Date (donor to OR) | ||||||
| Organ Recovery | Was this donor recovered under DCD protocol | ||||||
| Organ Recovery | If Yes, Controlled | ||||||
| Organ Recovery | If Yes, Date and time of withdrawal of support | ||||||
| Organ Recovery | If Yes, Date and time agonal phase begins (systolic BP < 80 or O2 sat. < 80%) | ||||||
| Organ Recovery | If DCD, Total urine output during OR recovery phase | ||||||
| Organ Recovery | DCD Measures//Date and time of measures | ||||||
| Organ Recovery | DCD Measures//Systolic blood pressure | ||||||
| Organ Recovery | DCD Measures//Systolic blood pressure//Status | Value or status is reported, not both | |||||
| Organ Recovery | DCD Measures//Diastolic blood pressure | ||||||
| Organ Recovery | DCD Measures//Diastolic blood pressure//Status | Value or status is reported, not both | |||||
| Organ Recovery | DCD Measures//Mean arterial pressure | ||||||
| Organ Recovery | DCD Measures//Mean arterial pressure//Status | Value or status is reported, not both | |||||
| Organ Recovery | DCD Measures//O2 saturation | ||||||
| Organ Recovery | DCD Measures//O2 saturation//Status | Value or status is reported, not both | |||||
| Organ Recovery | If Yes, Core Cooling Used | ||||||
| Organ Recovery | If yes, Date and time of abdominal aorta core cooling | ||||||
| Organ Recovery | Date and time of abdominal aorta core cooling://Status | Value or status is reported, not both | |||||
| Organ Recovery | If yes, Date and time of thoracic aorta core cooling | ||||||
| Organ Recovery | Date and time of thoracic aorta core cooling://Status | Value or status is reported, not both | |||||
| Organ Recovery | If yes, Date and time of portal vein core cooling | ||||||
| Organ Recovery | Date and time of portal vein core cooling://Status | Value or status is reported, not both | |||||
| Organ Recovery | If yes, Date and time of pulmonary artery core cooling | ||||||
| Organ Recovery | Date and time of pulmonary artery core cooling://Status | Value or status is reported, not both | |||||
| Organ Recovery | If No, Was this a consented DCD donor that progressed to brain death? | ||||||
| Organ Recovery | Clamp Date | ||||||
| Organ Recovery | Clamp Time: (Military Time) | ||||||
| Organ Recovery | Clamp Time //Status | Value or status is reported, not both | |||||
| Organ Recovery | Clamp Time Zone | ||||||
| Organ Recovery | History of previous MI | ||||||
| Organ Recovery | LV ejection fraction (%) | ||||||
| Organ Recovery | LV Ejection Fraction % //Status | Value or status is reported, not both | |||||
| Organ Recovery | Method | ||||||
| Organ Recovery | Structural Abnormalities //Valves | ||||||
| Organ Recovery | Structural Abnormalities //Congenital | ||||||
| Organ Recovery | Structural Abnormalities //LVH | ||||||
| Organ Recovery | Wall Abnormalities //Segmental | ||||||
| Organ Recovery | Wall Abnormalities //Global | ||||||
| Organ Recovery | Heart machine perfusion | ||||||
| Organ Recovery | Coronary Angiogram | ||||||
| Organ Recovery | If Abnormal, # of Vessels with > 50% Stenosis | ||||||
| Organ Recovery | ABG Results | Display Only | |||||
| Organ Recovery | Blood pH | ||||||
| Organ Recovery | PH //Status | Value or status is reported, not both | |||||
| Organ Recovery | PCO<sub>2 | ||||||
| Organ Recovery | PCO2 //Status | Value or status is reported, not both | |||||
| Organ Recovery | PO2 | ||||||
| Organ Recovery | PO2//Status | Value or status is reported, not both | |||||
| Organ Recovery | FiO2 | ||||||
| Organ Recovery | FiO2//Status | Value or status is reported, not both | |||||
| Organ Recovery | PEEP | ||||||
| Organ Recovery | PEEP//Status | Value or status is reported, not both | |||||
| Organ Recovery | Ventilator Mode | ||||||
| Organ Recovery | Ventilator Mode//Other Specify | ||||||
| Organ Recovery | Was a pulmonary artery catheter placed | ||||||
| Organ Recovery | MAP (initial) // MAP: (mm Hg) | ||||||
| Organ Recovery | MAP (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | MAP (final) // MAP: (mm Hg) | ||||||
| Organ Recovery | MAP (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | CVP (initial) // CVP: (mm Hg) | ||||||
| Organ Recovery | CVP (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | CVP (final) // CVP: (mm Hg) | ||||||
| Organ Recovery | CVP (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | PCWP (initial) // PCWP: (mm Hg) | ||||||
| Organ Recovery | PCWP (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | PCWP (final) // PCWP: (mm Hg) | ||||||
| Organ Recovery | PCWP (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | SVR (initial) //SVR: ((dynes/sec/cm)^5) | ||||||
| Organ Recovery | SVR (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | SVR (final) //SVR | ||||||
| Organ Recovery | SVR (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | PA Systolic (initial) // PA Systolic: (mm Hg) | ||||||
| Organ Recovery | PA Systolic (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | PA Systolic (final) // PA Systolic: (mm Hg) | ||||||
| Organ Recovery | PA Systolic (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | PA Diastolic (initial) // PA Diastolic: (mm Hg) | ||||||
| Organ Recovery | PA Diastolic (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | PA Diastolic (final) // PA Diastolic: (mm Hg) | ||||||
| Organ Recovery | PA Diastolic (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | CO (initial) (L/min) //CO: (L/min) | ||||||
| Organ Recovery | CO (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | CO (final) (L/min) //CO | ||||||
| Organ Recovery | CO (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | Cardiac Index (initial) //Cardiac Index: (L/min/sq.m) | ||||||
| Organ Recovery | Cardiac Index (initial) //Status | Value or status is reported, not both | |||||
| Organ Recovery | Cardiac Index (final) //Cardiac Index | ||||||
| Organ Recovery | Cardiac Index (final) //Status | Value or status is reported, not both | |||||
| Organ Recovery | Biopsy (heart donors only) | ||||||
| Organ Recovery | Other Diagnosis /Specify | ||||||
| Organ Recovery | Any Extracorporeal Support Given | ||||||
| Organ Recovery | How long: | ||||||
| Organ Recovery | How long://Status | Value or status is reported, not both | |||||
| Organ Recovery | Flow Rate | ||||||
| Organ Recovery | Flow Rate//Status | Value or status is reported, not both | |||||
| Organ Recovery | Left Kidney Biopsy | ||||||
| Organ Recovery | Type of Biopsy | ||||||
| Organ Recovery | Type of Biopsy//Specify | ||||||
| Organ Recovery | Interstitial Fibrosis | ||||||
| Organ Recovery | Vascular Changes | ||||||
| Organ Recovery | Number of Glomeruli Visualized | ||||||
| Organ Recovery | % Glomerulosclerosis (Left Kidney) //Glomerulosclerosis | ||||||
| Organ Recovery | Pump (Left Kidney) //Pump | ||||||
| Organ Recovery | Final Resistance Prior to Shipping (left) //Final Resistance Prior to Shipping | ||||||
| Organ Recovery | Final Resistance Prior to Shipping (left) //Status | Value or status is reported, not both | |||||
| Organ Recovery | Transferred on pump (left):// Transferred to transplant center on pump | ||||||
| Organ Recovery | Type of Left Kidney Pump/Machine | ||||||
| Organ Recovery | Type of Left Kidney Pump/Machine//Specify | ||||||
| Organ Recovery | Kidney Biopsy (right)://Right Kidney Biopsy | ||||||
| Organ Recovery | Type of Biopsy | ||||||
| Organ Recovery | Type of Biopsy//Specify | ||||||
| Organ Recovery | Interstitial Fibrosis | ||||||
| Organ Recovery | Vascular Changes | ||||||
| Organ Recovery | Number of Glomeruli Visualized | ||||||
| Organ Recovery | % Glomerulosclerosis (Right Kidney)://Glomerulosclerosis | ||||||
| Organ Recovery | Pump (Right Kidney) //Pump | ||||||
| Organ Recovery | Final Resistance Prior to Shipping (right) //Final Resistance Prior to Shipping | ||||||
| Organ Recovery | Final Resistance Prior to Shipping (right) //Status | Value or status is reported, not both | |||||
| Organ Recovery | Transferred on pump (right):// Transferred to transplant center on pump | ||||||
| Organ Recovery | Type of Right Kidney Pump/Machine | ||||||
| Organ Recovery | Type of Right Kidney Pump/Machine//Specify | ||||||
| Organ Recovery | Liver Biopsy | ||||||
| Organ Recovery | Type of Liver Biopsy | ||||||
| Organ Recovery | Type of Liver Biopsy//Specify | ||||||
| Organ Recovery | Fibrosis | ||||||
| Organ Recovery | Portal Infilitrates | ||||||
| Organ Recovery | % Macro vesicular fat | ||||||
| Organ Recovery | % Macro vesicular fat //Status | Value or status is reported, not both | |||||
| Organ Recovery | % Micro/intermediate vesicular fat | ||||||
| Organ Recovery | % Micro/intermediate vesicular fat //Status | Value or status is reported, not both | |||||
| Organ Recovery | Liver Machine Perfusion | ||||||
| Organ Recovery | Type of Liver Machine Perfusion | ||||||
| Organ Recovery | Type of Liver Machine Perfusion//Specify | ||||||
| Organ Recovery | Left Lung Bronchoscopy | ||||||
| Organ Recovery | Left Lung Machine Perfusion | ||||||
| Organ Recovery | Right Lung Bronchoscopy | ||||||
| Organ Recovery | Right Lung Machine Perfusion | ||||||
| Organ Recovery | Chest X-ray | ||||||
| Organ Dispostion | Disposition of Organ - Right Kidney://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time right kidney recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: RKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: RKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: RKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Right Kidney://Reason Code | ||||||
| Organ Dispostion | Reason Code Right Kidney //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted - Right Kidney://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Right Kidney //Specify | ||||||
| Organ Dispostion | Recovery Team# - Right Kidney://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Right Kidney://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush - Right Kidney //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Right Kidney://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Right Kidney //Specify | ||||||
| Organ Dispostion | chest X-ray | ||||||
| Organ Dispostion | Final Flush Right Kidney //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: RKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: RKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: RKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Left Kidney://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time left kidney recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: LKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: LKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: LKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Left Kidney://Reason Code | ||||||
| Organ Dispostion | Reason Code Left Kidney //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted - Left Kidney://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Left Kidney //Specify | ||||||
| Organ Dispostion | Recovery Team# - Left Kidney://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Left Kidney://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush - Left Kidney //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Left Kidney://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Left Kidney //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Left Kidney://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Left Kidney //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: LKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: LKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: LKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Double/En-bloc Kidney://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time double/en-bloc kidney recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: EKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: EKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: EKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Double/En-bloc Kidney://Reason Code | ||||||
| Organ Dispostion | Reason Code - Double/En-bloc Kidney //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Double/En-bloc Kidney://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted - Double/En-bloc Kidney //Specify | ||||||
| Organ Dispostion | Recovery Team# - Double/En-bloc Kidney://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Double/En-bloc Kidney://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush - Double/En-bloc Kidney //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Double/En-bloc Kidney://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Double/En-bloc Kidney //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Double/En-bloc Kidney://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Double/En-bloc Kidney //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: EKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: EKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: EKI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Pancreas://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time whole pancreas recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: PA | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: PA | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: PA | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Pancreas://Reason Code | ||||||
| Organ Dispostion | Reason Code - Pancreas //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Pancreas://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Pancreas //Specify | ||||||
| Organ Dispostion | Recovery Team# - Pancreas://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Pancreas://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Pancreas //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Back Table Flush Solution - Pancreas://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Pancreas //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution Volume | ||||||
| Organ Dispostion | Back Table Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Final Flush Solution - Pancreas://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Pancreas //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: PA | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: PA | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: PA | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Pancreas Segment 1://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date, and time pancreas segment 1 recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: PAS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: PAS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: PAS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Pancreas Segment 1://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Pancreas Segment 1 //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Pancreas Segment 1://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Pancreas Segment 1 //Specify | ||||||
| Organ Dispostion | Recovery Team# - Pancreas Segment 1://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Pancreas Segment 1://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Pancreas Segment 1 //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Back Table Flush Solution - Pancreas Segment 1://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Pancreas Segment 1 //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution Volume | ||||||
| Organ Dispostion | Back Table Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Final Flush Solution - Pancreas Segment 1://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Pancreas Segment 1 //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: PAS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: PAS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: PAS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Pancreas Segment 2://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time pancreas segment 2 recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: PAS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: PAS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: PAS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Pancreas Segment 2://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Pancreas Segment 2 //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Pancreas Segment 2://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Pancreas Segment 2 //Specify | ||||||
| Organ Dispostion | Recovery Team# - Pancreas Segment 2://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Pancreas Segment 2://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Pancreas Segment 2 //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Back Table Flush Solution - Pancreas Segment 2://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Pancreas Segment 2 //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution Volume | ||||||
| Organ Dispostion | Back Table Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Final Flush Solution - Pancreas Segment 2://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Pancreas Segment 2 //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: PAS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: PAS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: PAS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Liver://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time whole liver recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: LI | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: LI | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: LI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Liver://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Liver //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Liver://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Liver //Specify | ||||||
| Organ Dispostion | Recovery Team# - Liver://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Liver://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Liver //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Back Table Flush Solution - Liver://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Liver //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution Volume | ||||||
| Organ Dispostion | Back Table Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Final Flush Solution - Liver://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Liver //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: LI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: LI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: LI | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Liver Segment 1://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time liver segment 1 recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: LIS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: LIS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: LIS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Liver Segment 1://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Liver Segment 1 //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Liver Segment 1://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Liver Segment 1 //Specify | ||||||
| Organ Dispostion | Recovery Team# - Liver Segment 1://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Liver Segment 1://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Liver Segment 1 //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Back Table Flush Solution - Liver Segment 1://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Liver Segment 1 //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution Volume | ||||||
| Organ Dispostion | Back Table Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Final Flush Solution - Liver Segment 1://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Liver Segment 1 //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: LIS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: LIS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: LIS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Liver Segment 2://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time liver segment 2 recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: LIS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: LIS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: LIS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Liver Segment 2://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Liver Segment 2 //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Liver Segment 2://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Liver Segment 2 //Specify | ||||||
| Organ Dispostion | Recovery Team# - Liver Segment 2://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Liver Segment 2://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Liver Segment 2 //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Back Table Flush Solution - Liver Segment 2://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Liver Segment 2 //Specify | ||||||
| Organ Dispostion | Initial Flush Solution Volume | ||||||
| Organ Dispostion | Initial Flush Solution Volume//Status | Value or status is reported, not both | |||||
| Organ Dispostion | Final Flush Solution - Liver Segment 2://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Liver Segment 2 //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: LIS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: LIS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: LIS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Intestine://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time whole intestine recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: IN | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: IN | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: IN | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Intestine://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Intestine //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Intestine ://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Intestine //Specify | ||||||
| Organ Dispostion | Recovery Team# - Intestine://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Intestine://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Intestine //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Intestine://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Intestine //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Intestine://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Intestine //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: IN | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: IN | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: IN | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Intestine Segment 1://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time intestine segment 1 recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: INS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: INS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: INS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Intestine Segment 1://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Intestine Segment 1 //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Intestine Segment 1://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Intestine Segment 1 //Specify | ||||||
| Organ Dispostion | Recovery Team# - Intestine Segment 1://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Intestine Segment 1://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Intestine Segment 1 //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Intestine Segment 1://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Intestine Segment 1 //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Intestine Segment 1://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Intestine Segment 1 //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: INS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: INS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: INS1 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Intestine Segment 2://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time intestine segment 2 recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: INS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: INS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: INS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Intestine Segment 2://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Intestine Segment 2 //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Intestine Segment 2://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Intestine Segment 2 //Specify | ||||||
| Organ Dispostion | Recovery Team# - Intestine Segment 2://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Intestine Segment 2://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Intestine Segment 2 //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Intestine Segment 2://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Intestine Segment 2 //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Intestine Segment 2://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Intestine Segment 2 //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: INS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: INS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: INS2 | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Heart://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time heart recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: HR | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: HR | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: HR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Heart://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Heart //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Heart://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Heart //Specify | ||||||
| Organ Dispostion | Recovery Team# - Heart://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Heart://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Heart //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Heart://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Heart //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Heart://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Heart //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: HR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: HR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: HR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Right Lung://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time left lung recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: LUL | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: LUL | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: LUL | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Right Lung://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Right Lung //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Right Lung://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Right Lung //Specify | ||||||
| Organ Dispostion | Recovery Team# - Right Lung://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Right Lung://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Right Lung //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Right Lung://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Right Lung //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Right Lung://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Right Lung //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: LUL | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: LUL | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: LUL | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Left Lung://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time right lung recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: LUR | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: LUR | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: LUR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Left Lung://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - Left Lung //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Left Lung://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Left Lung //Specify | ||||||
| Organ Dispostion | Recovery Team# - Left Lung://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Left Lung://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Left Lung //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Left Lung://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Left Lung //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Left Lung://Final Flush/Storage Solution | ||||||
| Organ Dispostion | Final Flush Solution Specify - Left Lung //Specify | ||||||
| Organ Dispostion | OPO sent vessels with organ: LUR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: LUR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: LUR | Display Only - Cascades from Database | |||||
| Organ Dispostion | Disposition of Organ - Double/En-bloc Lung://Organ | Display Only - Cascades from feedback | |||||
| Organ Dispostion | If DCD, date and time double/en-bloc lung recovered/removed from donor | ||||||
| Organ Dispostion | Recipient: DLU | Display Only - Cascades from Database | |||||
| Organ Dispostion | SSN: DLU | Display Only - Cascades from Database | |||||
| Organ Dispostion | TX Center: DLU | Display Only - Cascades from Database | |||||
| Organ Dispostion | Reason Code - Double/En-bloc Lung://Reason Code | ||||||
| Organ Dispostion | Reason Code/Specify - DoubleEn-bloc Lung //Specify | ||||||
| Organ Dispostion | Reason organ not transplanted -Double/En-bloc Lung://Reason organ not transplanted | ||||||
| Organ Dispostion | Reason organ not transplanted Other Specify - Double/En-bloc Lung //Specify | ||||||
| Organ Dispostion | Recovery Team# - Double/En-bloc Lung://Recovery Team# | ||||||
| Organ Dispostion | Initial Flush Solution - Double/En-bloc Lung://Initial Flush Solution | ||||||
| Organ Dispostion | Initial Flush Other Specify - Double/En-bloc Lung //Specify | ||||||
| Organ Dispostion | Back Table Flush Solution - Double/En-bloc Lung://Back Table Flush Solution | ||||||
| Organ Dispostion | Back Table Flush Solution Specify - Double/En-bloc Lung //Specify | ||||||
| Organ Dispostion | Final Flush Solution Specify - Double/En-bloc Lung //Specify | ||||||
| Organ Dispostion | Final Flush Solution - Double/En-bloc Lung://Final Flush/Storage Solution | ||||||
| Organ Dispostion | OPO sent vessels with organ: DLU | Display Only - Cascades from Database | |||||
| Organ Dispostion | Were extra vessels used in the transplant procedure: DLU | Display Only - Cascades from Database | |||||
| Organ Dispostion | Vessel Donor ID: DLU | Display Only - Cascades from Database | |||||
| PUBLIC BURDEN STATEMENT: | |||||||
| The private, non-profit Organ Procurement and Transplantation Network (OPTN) collects this information in order to perform the following OPTN functions: to assess whether applicants meet OPTN Bylaw requirements for membership in the OPTN; and to monitor compliance of member organizations with OPTN Obligations. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0915-0157 and it is valid until XX/XX/20XX. This information collection is required to obtain or retain a benefit per 42 CFR §121.11(b)(2). All data collected will be subject to Privacy Act protection (Privacy Act System of Records #09-15-0055). Data collected by the private non-profit OPTN also are well protected by a number of the Contractor’s security features. The Contractor’s security system meets or exceeds the requirements as prescribed by OMB Circular A-130, Appendix III, Security of Federal Automated Information Systems, and the Departments Automated Information Systems Security Program Handbook. The public reporting burden for this collection of information is estimated to average 3 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected]. |
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| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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