Donor Information
Serologies & Labs
Medications
LifeStyle/Management
Procurement & Disposition
100
The cause of death, the mechanism of death and the circumstances of death for a donor that died as a result of a self-inflicted hanging?
What is: Anoxia Asphyxiation Suicide
100
The value of the laboratory test performed closes to the time of recovery
What is terminal lab data
100
The most commonly missed medication administered within 24 hours prior to crossclamp for LifeSource donors on the DDR
What is steroids. (solumedrol)
100
Signs of clinical infection; (list multiple sources)
What is: Bacteria in Urinalysis Bacteria in Sputum Gram Stain Comment of infection in progress notes Any Drainage Unexplained elevated temp & WBC (beyond neuro injury response) Consolidation on chest x-ray etc.
100
A DCD type of donor whose lifesupport will be withdrawn and whose family gave written consent for organ donation in the controlled environment of the operating room.
What is controlled DCD donation.
200
The Medical Examiner is always contacted even if it is not an ME case.
What is any organ donor. UNOS wants to know if we contact the ME, it is not asking if it is an ME case.
200
The result of HTLV testing for organ donors at LifeSource
What is Not Done.
200
Antibiotics are documented in this area.
What is What is "Other/Specify" category
200
Cigarette use (>20pack years)
What is # of packs smoked per day X # of years smoked = pack years UNOS wants documentation of Cigarette use only if >20 pack years)
200
LifeSource uses core cooling routinely.
What is no.
300
Consent is based solely on this date & time documentation of designated donor in a DCD case.
What is time of authorization. This is a DCD case so the family authorized for donoation. UNOS wants to know if consent is based solely on documentation. In the case of DCD we currently also obtain authorization from the family.
300
Location of many terminal Labs
What is the anesthesia record.
300
Dosage at time of cross clamp of intropic medications.
What is What is the length of time the last change in dose amount was made prior to cross clamp.
300
The number of drinks a day that UNOS considers heavy alcohol use.
What is 2+drinks/ day
300
We document the time of abdominal aorta cannulation on this form.
What is none. We do not currently document this time. In the DDR we should respond with "unknown".
400
When is the date and time of pronouncement of death?
It is determined by hospital protocol.
400
Two labs required for pancreas donors
What are Lipase and Amylase results.
400
Terminal pO2 results are often found here.
What is Anesthesia record
400
Three methods of hypertension control
What is diet, diuretics (water pills), other medications
400
Cardiac arrest since neurological event is checked if the donor ever had an arrest.
What is no. UNOS is looking for only if the arrest occurred after the primary event causing the brain injury. In the case of a donor who suffers brain injury as a result of an arrest, this should be checked no.
500
What is the time of consent in the case of a brain dead donor with donor designation?
What is time of brain death. Because this person had donor designation, the time of "consent" is the time of death.
500
Transfusions during this (terminal) hospitalization included 2 units of packed red blood cells, four FFP. UNOS considers this the number of transfusions.
What are 2 transfusions. UNOS considers transfusions to include only packed red blood cells or whole blood transfusions.
500
Heparin is given prior to procurement and is documented in this location in the DDR
What is the Any medication administered within 24 hours of cross-clamp section of the DDR.
500
Considered an abnormal angiogram finding by UNOS
What is greater than 50% senosis in one or more coronary artery.
500
Often confused as a liver biopsy for LifeSource, however is done by the transplant center as part of their usual protocol.
What is Mayo Liver biopsy We do not have to check yes to biopsy unless we obtain a biopsy with results received prior to transplant.
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