69 Donor Organ Disposition

Donor Organ Disposition
Fields to be completed by members
Form Section	Field Label	Notes
Donor Organ Disposition	OPO	Display only - Cascades from database
Donor Organ Disposition	Donor hospital	Display only - Cascades from database
Donor Organ Disposition	Histocompatibility lab
Donor Organ Disposition	Donor name	Display only - Cascades from database
Donor Organ Disposition	Date of referral call
Donor Organ Disposition	Recovery date
Donor Organ Disposition	Were any organs recovered?
Donor Organ Disposition	Right Kidney Disposition (supply code)
Donor Organ Disposition	Right Kidney Code
Donor Organ Disposition	Right Kidney Match ID
Donor Organ Disposition	Right Kidney Tx Center
Donor Organ Disposition	Right Kidney Extra Vessel Sent
Donor Organ Disposition	Left Kidney Disposition (supply code)
Donor Organ Disposition	Left Kidney Code
Donor Organ Disposition	Left Kidney Match ID
Donor Organ Disposition	Left Kidney Tx Center
Donor Organ Disposition	Left Kidney Extra Vessel Sent
Donor Organ Disposition	Dual/En-bloc Kidney Disposition (supply code)
Donor Organ Disposition	Dual/En-bloc Kidney Code
Donor Organ Disposition	Dual/En-bloc Kidney Match ID
Donor Organ Disposition	Dual/En-bloc Kidney Tx Center
Donor Organ Disposition	Dual/En-bloc Kidney Extra Vessel Sent
Donor Organ Disposition	Pancreas Disposition (supply code)
Donor Organ Disposition	Pancreas Code
Donor Organ Disposition	Pancreas Match ID
Donor Organ Disposition	Pancreas Tx Center
Donor Organ Disposition	Pancreas Extra Vessel Sent
Donor Organ Disposition	Pancreas Segment 1 Disposition (supply code)
Donor Organ Disposition	Pancreas Segment 1 Code
Donor Organ Disposition	Pancreas Segment 1 Match ID
Donor Organ Disposition	Pancreas Segment 1 Tx Center
Donor Organ Disposition	Pancreas Segment 1 Extra Vessel Sent
Donor Organ Disposition	Pancreas Segment 2 Disposition (supply code)
Donor Organ Disposition	Pancreas Segment 2 Code
Donor Organ Disposition	Pancreas Segment 2 Match ID
Donor Organ Disposition	Pancreas Segment 2 Tx Center
Donor Organ Disposition	Pancreas Segment 2 Extra Vessel Sent
Donor Organ Disposition	Liver Disposition (supply code)
Donor Organ Disposition	Liver Code
Donor Organ Disposition	Liver Match ID
Donor Organ Disposition	Liver Tx Center
Donor Organ Disposition	Liver Extra Vessel Sent
Donor Organ Disposition	Liver Segment 1 Disposition (supply code)
Donor Organ Disposition	Liver Segment 1 Code
Donor Organ Disposition	Liver Segment 1 Match ID
Donor Organ Disposition	Liver Segment 1 Tx Center
Donor Organ Disposition	Liver Segment 1 Extra Vessel Sent
Donor Organ Disposition	Liver Segment 2 Disposition (supply code)
Donor Organ Disposition	Liver Segment 2 Code
Donor Organ Disposition	Liver Segment 2 Match ID
Donor Organ Disposition	Liver Segment 2 Tx Center
Donor Organ Disposition	Liver Segment 2 Extra Vessel Sent
Donor Organ Disposition	Intestine Disposition (supply code)
Donor Organ Disposition	Intestine Code
Donor Organ Disposition	Intestine Match ID
Donor Organ Disposition	Intestine Tx Center
Donor Organ Disposition	Intestine Extra Vessel Sent
Donor Organ Disposition	Intestine Segment 1 Disposition (supply code)
Donor Organ Disposition	Intestine Segment 1 Code
Donor Organ Disposition	Intestine Segment 1 Match ID
Donor Organ Disposition	Intestine Segment 1 Tx Center
Donor Organ Disposition	Intestine Segment 1 Extra Vessel Sent
Donor Organ Disposition	Intestine Segment 2 Disposition (supply code)
Donor Organ Disposition	Intestine Segment 2 Code
Donor Organ Disposition	Intestine Segment 2 Match ID
Donor Organ Disposition	Intestine Segment 2 Tx Center
Donor Organ Disposition	Intestine Segment 2 Extra Vessel Sent
Donor Organ Disposition	Heart Disposition (supply code)
Donor Organ Disposition	Heart Code
Donor Organ Disposition	Heart Match ID
Donor Organ Disposition	Heart Tx Center
Donor Organ Disposition	Heart Extra Vessel Sent
Donor Organ Disposition	Right Lung Disposition (supply code)
Donor Organ Disposition	Right Lung Code
Donor Organ Disposition	Right Lung Match ID
Donor Organ Disposition	Right Lung Tx Center
Donor Organ Disposition	Right Lung Extra Vessel Sent
Donor Organ Disposition	Left Lung Disposition (supply code)
Donor Organ Disposition	Left Lung Code
Donor Organ Disposition	Left Lung Match ID
Donor Organ Disposition	Left Lung Tx Center
Donor Organ Disposition	Left Lung Extra Vessel Sent
Donor Organ Disposition	Double/En bloc Lung Disposition (supply code)
Donor Organ Disposition	Double/En bloc Lung Code
Donor Organ Disposition	Double/En bloc Lung Match ID
Donor Organ Disposition	Double/En bloc Lung Tx Center
Donor Organ Disposition	Double/En bloc Extra Vessel Sent
Donor Organ Disposition	Was authorization for VCA organs requested?
Donor Organ Disposition	If no, specify Authorization Not Requested Code
Donor Organ Disposition	Abdominal Wall Disposition (supply code)
Donor Organ Disposition	Abdominal Wall Code
Donor Organ Disposition	Abdominal Wall Match ID
Donor Organ Disposition	Abdominal Wall Tx Center
Donor Organ Disposition	Abdominal Wall Extra Vessels Sent
Donor Organ Disposition	External Male Genitalia Disposition (supply code)
Donor Organ Disposition	External Male Genitalia Code
Donor Organ Disposition	External Male Genitalia Match ID
Donor Organ Disposition	External Male Genitalia Tx Center
Donor Organ Disposition	External Male Genitalia Extra Vessels Sent
Donor Organ Disposition	Head and Neck Disposition (supply code)
Donor Organ Disposition	Head and Neck Code
Donor Organ Disposition	Head and Neck Match ID
Donor Organ Disposition	Head and Neck Tx Center
Donor Organ Disposition	Head and Neck Extra Vessels Sent
Donor Organ Disposition	Lower Limb Disposition (supply code)
Donor Organ Disposition	Lower Limb Code
Donor Organ Disposition	Lower Limb Match ID
Donor Organ Disposition	Lower Limb Tx Center
Donor Organ Disposition	Lower Limb Extra Vessels Sent
Donor Organ Disposition	Musculoskeletal Composite Graft Segment Disposition (supply code)
Donor Organ Disposition	Musculoskeletal Composite Graft Segment Code
Donor Organ Disposition	Musculoskeletal Composite Graft Segment Match ID
Donor Organ Disposition	Musculoskeletal Composite Graft Segment Tx Center
Donor Organ Disposition	Musculoskeletal Composite Graft Segment Extra Vessels Sent
Donor Organ Disposition	Other Genitourinary Organ Disposition (supply code)
Donor Organ Disposition	Other Genitourinary Organ Code
Donor Organ Disposition	Other Genitourinary Organ Match ID
Donor Organ Disposition	Other Genitourinary Organ Tx Center
Donor Organ Disposition	Other Genitourinary Organ Extra Vessels Sent
Donor Organ Disposition	Spleen Disposition (supply code)
Donor Organ Disposition	Spleen Code
Donor Organ Disposition	Spleen Match ID
Donor Organ Disposition	Spleen Tx Center
Donor Organ Disposition	Spleen Extra Vessels Sent
Donor Organ Disposition	Upper Limb Disposition (supply code)
Donor Organ Disposition	Upper Limb Code
Donor Organ Disposition	Upper Limb Match ID
Donor Organ Disposition	Upper Limb Tx Center
Donor Organ Disposition	Upper Limb Extra Vessels Sent
Donor Organ Disposition	Uterus Disposition (supply code)
Donor Organ Disposition	Uterus Code
Donor Organ Disposition	Uterus Match ID
Donor Organ Disposition	Uterus Tx Center
Donor Organ Disposition	Uterus Extra Vessels Sent
Donor Organ Disposition	Vascularized Gland Disposition (supply code)
Donor Organ Disposition	Vascularized Gland Code
Donor Organ Disposition	Vascularized Gland Match ID
Donor Organ Disposition	Vascularized Gland Tx Center
Donor Organ Disposition	Vascularized Gland Extra Vessels Sent
Donor Organ Disposition	Organ accompanied	Read only - cascades from database
Donor Organ Disposition	Reporting facility	Read only - cascades from database
Donor Organ Disposition	Vessel Disposition	Read only - cascades from database
Donor Organ Disposition	Recovering facility	Read only - cascades from database
Donor Organ Disposition	Disposition date	Read only - cascades from database
Donor Organ Disposition	Reporting date	Read 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/202X. 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 0.27 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].