Donor Organ Disposition

OMB No. 0915-0157; Expiration Date: XX/XX/202X

Donor Organ Disposition

The disposition of organs from every donor is recorded through the Donor Organ Disposition Data function in UNet^SM. This information must be submitted within five working days from the procurement date.

OPO: OPO name. This field is populated automatically by the system.

Donor Hospital: Donor hospital name. This field is populated automatically by the system.

Histocompatibility lab: Select the name of the histocompatibility lab from the dropdown menu.

Donor name: The donor name is populated automatically by the system. The information cascades from the donor record.

Date of referral call: Enter the date of referral call (MM/DD/YYYY).

Recovery date: Enter the date (MM/DD/YYYY) the donor entered the operating room for the purpose of organ recovery. If the operation was started in the evening and concluded the next day, enter the date the operation began.

Were any organs recovered?:

Yes

No

If No is selected, the DDR will be suspended. If Yes is selected, then the disposition for at least one organ type must be Recovered for TX but not TX or Transplanted in order for a DDR to generate.

Provide the following disposition information for the applicable organ.

Organs:

Right Kidney	Right Lung
Left Kidney	Left Lung
Dual/En-bloc Kidney	Double/En-bloc Lung
Pancreas	Abdominal Wall
Pancreas Segment 1	External Male Genitalia
Pancreas Segment 2	Head and Neck
Liver	Lower Limb
Liver Segment 1	Musculoskeletal Composite Graft Segment
Liver Segment 2	Other Genitourinary
Intestine	Spleen
Intestine Segment 1	Upper Limb
Intestine Segment 2	Uterus
Heart	Vascularized Gland

Disposition (supply code): Select from the dropdown menu.

Authorization Not Requested

Authorization Not Obtained

Organ Not Recovered

Recovered Not for Tx

Recovered for Tx but Not Tx

Transplanted

Code: Select the applicable code from the dropdown menu.

Match ID: Match ID of the match that was used to allocate the organ. Select from the dropdown menu.

Tx Center: Transplant center code of the recipient center. Select from the dropdown menu.

Extra Vessel Sent: Check the checkbox if an extra vessel was sent. Extra vessels are taken during the organ procurement process of deceased or living donors with the intent to use them to reconstruct vasculature of a transplanted organ. Not everything directly attached to the organ (without surgical modification) to be transplanted is considered an extra vessel. Extra vessels are routinely taken from areas not immediately connected to the transplantable organ (i.e., iliac artery or vein, aorta, carotid artery or jugular vein, etc.)

Was authorization for at least one VCA organ requested?:

Yes

No

Specify the authorization not requested code:

Donor Age

Non-heart Beating Donor

Acute/chronic Renal Failure

Donor Quality

Donor ABO

Other Specify

Organ accompanied: This field is read-only.

Reporting facility: This field is read-only.

Vessel disposition: This field is read-only.

Recovering facility: This field is read-only.

Disposition date: This field is read-only.

Reporting date: This field is read-only.

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 Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, Maryland, 20857 or [email protected].   

OPTN Restricted