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View all expected patient follow-ups
UNOS_Employees
X YR Annual Follow Up - PATIENT NAME TX ID# XXXXX
TX DATE - X/XX/XXXX
FOLLOW-UP INFORMATION:
Follow-up Hospital Name and Provider Number:
01CN01-Royal Victoria Hospital
01CN02-Montreal Heart Institute
01CN03-The Toronto General Hospital - Heart Transplant Program
01CN03-The Toronto General Hospital - Heart/Lung Transplant Program
01CN03-The Toronto General Hospital - Lung Transplant Program
01CN04-Hospital Sainte-Justine
01CN05-Notre-Dame Hospital
01CN06-Hospital Notre-Dame
01CN07-Queen Elizabeth II
01CN08-Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ)
01CN09-Ottawa Heart Institute
01CN10-Health Sciences Centre
01CN11-University of Alberta Hospitals/Walter C. Mackenzie Health Sciences
01CN12-University of British Columbia
01CN13-St. Paul's Hospital
01CN14-University Campus, London Health Sciences Centre
01CN15-Vancouver General Hospital
01CN16-The Hospital For Sick Children - Heart Transplant Program
01CN16-The Hospital for Sick Children - Heart/Lung Transplant Program
01CN16-The Hospital For Sick Children - Lung Transplant Program
01CN17-BC Children's Hospital
01CT02-Hospital Rafael Angel Calderon Guardia
01MX02-Instituto Mexicano Seguro Social
01PM02-Hospital Punta Pacifica
01US02-Columbia University College of Physicians and Surgeons
01US03-Baylor University Medical Center
02AR01-FUNDACION FAVALORO
02AR01-Fundacion Favaloro
02AR02-HAREFIELD S.A. - HOSPITAL ITALIANO DE MENDOZA
02AR02-Hospital Italiano Mendoza
02AR03-SANATORIO PLAZA
02AR04-INSTITUTO CARDIOVASCULAR DE ROSARIO
02AR05-CENTRO DE TRASPLANTE CARDIACO HOSPITAL PRIVADO CORDOBA
02AR05-Hospital Privado de Cordoba
02AR06-Hospital Italiano
02AR06-HOSPITAL ITALIANO DE BUENOS AIRES
02AR07-INSTITUTO DE CARDIOLOGIA S.A.
02AR07-Instituto De Cardiologia- Hospital Espanol
02AR08-SANATORIO SANTA ISABEL
02AR08-Santorio Santa Isabel
02AR09-Hospital Israelita
02AR10-HOSPITAL INTERZONAL GENERAL DE AGUDOS PRESIDENTE PERON
02AR11-SANATORIO ALLENDE
02AR12-HOSPITAL UNIVERSITARIO AUSTRAL
02AR13-HOSPITAL DE PEDIATRIA PEDRO DE ELIZALDE
02AR14-HOSPITAL EL CRUCE
02AR15-HOSPITAL ESPAÑOL DE MENDOZA
02AR16-HOSPITAL FRANCES
02AR17-CENTRO DE PROGRAMA DE TRASPLANTE CARDIACO CLINICA VELEZ SARSFIELD
02AR19-CENTRO DE TRASPLANTE CARDIACO DEL SANATORIO ALLENDE
02AR20-CENTRO DE TRASPLANTE CARDIACO HOSPITAL ITALIANO CORDOBA
02AR21-CENTRO DE TRASPLANTE PULMONAR HOSPITAL ITALIANO CORDOBA
02AR22-CENTRO PRIVADO DE CARDIOLOGIA SRL
02AR23-CENTRO PRIVADO DE TRASPLANTE
02AR24-CLINICA DE NEFROLOGIA UROLOGIA Y ENFERMEDADES CARDIOVASCULARES
02AR25-FLENI
02AR28-HOSPITAL DE CLINICAS JOSE DE SAN MARTIN
02AR29-HOSPITAL ALEMAN
02AR30-HOSPITAL CORDOBA
02AR31-HOSPITAL DE ALTA COMPLEJIDAD PTE JUAN DOMINGO PERON
02AR32-HOSPITAL DE PEDIATRIA JUAN P GARRAHAN
02AR33-HOSPITAL GENERAL DE AGUDOS DR COSME ARGERICH
02AR34-HOSPITAL INTERZONAL DE AGUDOS ESPECIALIZADO EN PEDIATRIA SOR MARIA LUDOVICA
02AR36-HOSPITAL ITALIANO GARIBALDI
02AR37-HOSPITAL PRIVADO DEL SUR
02AR38-INSTITUTO CARDIOVASCULAR DE BUENOS AIRES
02AR39-INSTITUTO DE CARDIOLOGIA SRL
02AR40-INSTITUTO DE CARDIOLOGIA DE CORRIENTES JUANA F CABRAL
02AR42-INSTITUTO DEL CORAZON DENTON COOLEY
02AR43-INSTITUTO MODELO DE CARDIOLOGIA PRIVADO
02AR44-PROGRAMA DE TRASPLANTE PULMONAR HOSPITAL PRIVADO CORDOBA
02AR45-SANATORIO DE LA TRINIDAD MITRE
02AR46-SANATORIO PARQUE
02BR01-Heart Institute-Univ. Sao Paulo Hospital das Clinicas
02BR02-Sao Paulo Hospital
02BR03-Biocor Hospital
02BR04-Hospital de Messejana
02BR05-Real Hospital Portugues de Beneficiencia Em Pernambuco
02BR06-Instituto de Medicina Integral
02BR07-Instituto de Cardiologia do Distrito Federal
02BR08-Hospital de Clinicas de Porto Alegre
02BR09-Instituto Nacional de Cardiologia
02BR10-Hospital das Clinicas
02BR11-Procardiaco Hospital
02BR12-Hospital Meridional
02BV02-Centro Medico Quirurgico Boliviano Belga
02CH01-Hospital DIPRECA
02CH02-Clinica Las Condes
02CH03-Hospital Gustavo Fricke
02CH04-Instituto Nacional del Torax
02CO01-Clinica Cardiovascular
02CO02-San Ignacio University Hospital
02CO03-Hospital Universitario San Vicente De Paul-Universidad De Antioquia
02CO04-Fundacion Valle Del Lili
02CO05-Fundacion Cardioinfantil-Instituto de Cardiologia
02CO06-Fundacion Cardiovascular de Colombia
02CO07-Fundacion Clinica Shaio
02CO08-Dime Clinica Neurocardiovascular
02CO09-Clinica Universitaria Colombia
02PE02-Instituto Nacional Cardiovascular INCOR
03SF01-Groote Schuur Hospital
03SF02-Milpark Hospital
04BY02-RSPC Cardiology
04HK02-Queen Mary Hospital
04IN02-Sir Ganga Ram Hospital
04IN03-Apollo Hospital
04IN04-Fortis Malar Hospital
04IN05-Fortis Hospital
04IN06-Gleneagles Global Health City
04IN07-Global Gleneagles Hospitals, Hyderabad
04IN08-Eternal Hospital
04IN09-CIMS (Care Institute of Medical Sciences) Hospital
04IR01-Modarres General Hospital
04IR02-Cardiac Surgery & Transplantation Research Center
04IR03-Imam Khomeini Hospital Complex
04IR04-Masih Daneshvari Hospital
04IR05-Rajaie Cardiovascular, Medical and Research Center
04IS01-Rabin Medical Center (Belinson Campus)
04IS02-Sheba Medical Center
04IS03-Hadassah University Hospital
04JP01-Tohoku University Hospital
04JP02-Osaka University Hospital
04JP03-National Cardiovascular Center
04JP04-Tokyo Women's Medical University
04JP05-Kyoto University Hospital
04JP06-Saitama Medical School Hospital
04JP07-Kyushu University Hospital
04JP08-Okayama University Hospital
04JR01-Queen Alia Heart Inst
04JR02-Arab Center for Heart and Special Surgery
04KO01-Kang-Nam St. Mary
04KO02-Gachon Medical College, Ghil Hospital
04KO03-Seoul National University Hospital
04KO04-Ulsan University Hospital
04KO05-Asan Medical Center
04KO06-Gangnam Severance Hospital
04KO07-Severance Hospital
04KZ02-National Research Center For Cardiac Surgery
04PH01-Makati Medical Center - Makati Heart Foundation
04RU01-Federal V. Shumakov Research Centre of Transplantology & Artificial Organs
04RU02-Research Institute S.V. Ochapowski Regional Hospital #1
04SA01-King Faisal Specialist Hosp & Research Center
04SI01-National Heart Centre
04TH01-ASEAN Registry
04TH02-Mahidol University, Siriraj Hospital
04TH03-Chulalongkorn Hosp & Univ
04TK01-Turkiye Yuksek Intisas Hospital
04TK02-Dokuz Eylul University Hospital
04TK03-Sureyyapasa Chest Disease & Thoracic Surgery Research Hospital
04TK04-Siyami Ersek Thoracic and Cardiovascular Surgery
04TK05-Istanbul Florence Nightingale Hospital
04TK06-Heart Center, Ankara University
04TK07-Hospital of Akdeniz University
04TK08-Ege University Medical School
04TK09-Kartal-Kosuyolu YIEAH Hospital
04TK10-Mehmet Akif Ersoy Thoracic& Cardiovascular Surgery Center and Research
04TW01-Cheng-Hsin General Hosptial
04TW02-Tri-Service General Hospital
04TW03-National Taiwan University Hospital
04TW04-Kaohsiung Veterans General Hospital
04TW05-Far Eastern Memorial Hospital
04TW06-China Medical College Hospital
05NZ01-Green Lane Hospital
06IR01-Mater Hospital
06UK01-Killingbeck Hospital
06UK02-Great Ormond Street Hospital for Children
06UK03-The Royal London Hospital
06UK04-St. Bartholomews Hospital
06UK05-General Infirmary
06UK06-Royal Infirmary
06UK07-University of Glasgow/Glasgow Royal Infirmary
06UK09-Addenbrooke's Hospital
06UK10-Northern General Hospital
06UK11-The Freeman Hospital
06UK12-Harefield Hosp
06UK13-Wythenshawe Hospital
06UK14-St. George's Hospital
06UK15-Queen Elizabeth Hospital
06UK16-Papworth Hospital
07AU01-Allgemeines Krankenhaus Wien (AWGTP)
07AU02-Universitätsklinik Innsbruck (AIBTP)
07AU03-Landeskrankenhaus Graz (AGATP)
07BL01-Hôpital Erasme Bruxelles (BBRTP)
07BL02-University Hospital Gasthuisberg/Catholic Univ. of Leuven
07BL03-Universitair Ziekenhuis Antwerpen (BANTP)
07BL04-Onze Lieve Vrouw Ziekenhuis Aalst (BASTP)
07BL05-Cliniques Universitaires St. Luc
07BL06-Universitair Ziekenhuis Gent (BGETP)
07BL07-Akademisch Ziekenhuis VUB, Jette (BBJTP)
07BL08-Cliniques Universitaires de Mont Godinne
07BL10-Centre Hospitalier Universitaire Liège (BLGTP)
07BL11-Cliniques Universitaires, Université Catholique de Louvain (BLATP)
07BL12-UZ Gasthuisberg Leuven (BLMTP)
07CR01-University Clinical Hospital Zagreb (CZATP)
07CR02-University Hospital Dubrava (CZDTP)
07GM01-Universität des Saarlandes Homburg/Saar (GHSTP)
07GM02-Martin-Luther-Universität Halle (GHATP)
07GM03-Herzzentrum Dresden GmbH (GDRTP)
07GM04-Deutsches Herzzentrum Berlin (GBDTP)
07GM05-Universitat Hamburg, Chirurgische Klinik and Poliklinik
07GM06-Berufsgenossenschaftliche Kliniken Bochum (GBBTP)
07GM07-Univ.Klin.Humboldt Universität zu Berlin (GBSTP)
07GM08-Universitätsklinik Köln (GKLTP)
07GM09-Universität Leipzig - Herzzentrum (GLPTP)
07GM10-Kerckhoff Klinik, Bad Nauheim (GBHTP)
07GM11-Klinikum der Universität Regensburg (GRBTP)
07GM12-Herzzentrum Nordrhein-Westfalen Bad Oeynhausen (GBATP)
07GM13-Chirurgische. Universitaetsklinik/University Hospital Freiburg
07GM14-Universitätsklinikum Essen (GESTP)
07GM16-Benedikt-Kreutz Rehabilitationszentrum Bad Krozingen (GBKTP)
07GM17-Johannes Gutenberg Universität Mainz (GMZTP)
07GM18-Heinrich-Heine-Universität Düsseldorf (GDUTP)
07GM19-Universitätsklinikum Münster (GMNTP)
07GM20-German Heart Center
07GM21-Klinikum GroBhadern, Ludwig-Maximilians-Universitat Muchen
07GM22-Klinikum der Justus-Liebig-Univ.
07GM23-Westpfalzklinikum Kaiserslautern (GKSTP)
07GM24-Ruprecht-Karls-Universität Heidelberg (GHBTP)
07GM25-Medizinische Hochschule Hannover (GHOTP)
07GM26-Universitätsklinikum Göttingen (GGOTP)
07GM27-Universitätsklinikum Aachen (GAKTP)
07GM28-Klinikum Fulda (GFDTP)
07GM29-Klinikum der Justus-Liebig-Universität Giessen (GGITP)
07GM30-Universitätsklinikum Schleswig-Holstein Kiel (GKITP)
07GM31-Johann Wolfgang Goethe Universität Frankfurt/Main (GFMTP)
07GM32-Friedrich Schiller Universität Jena (GJETP)
07GM33-Klinikum Karlsburg (GKGTP)
07GM34-Klinik für Herzchirurgie Karlsruhe GmbH (GKRTP)
07GM35-Universitätsklinikum Erlangen-Nürnberg (GNBTP)
07GM36-Universitätsklinikum Würzburg (GWZTP)
07GM37-University Hospital Munster
07GM38-Ludwig Maximilians Universität München (GMLTP)
07GM39-Deutsches Herzzentrum München (GMDTP)
07GM40-Universitätsklinikum Hamburg (GHGTP)
07GM41-Eberhard Karls Universität Tübingen (GTUTP)
07GM42-Klinikum der Albert-Ludwigs-Universität Freiburg im Breisgau (GFRTP)
07GM43-Klinikum der Universität Rostock (GROTP)
07GM44-Universitaetsklinikum Benjamin Franklin (GBETP)
07NL01-Universitair Medisch Centrum Utrecht (NUTTP)
07NL02-St. Antonius Ziekenhuis Nieuwegein (NUATP)
07NL03-Erasmus Medisch Centrum Rotterdam (NRDTP)
07NL04-Universitair Medisch Centrum Groningen (NGRTP)
07NL05-Leids Universitair Medisch Centrum (NLBTP)
07SL01-University Medical Center Ljubljana (SLOTP)
08CZ01-Institute for Clinical and Experimental Medicine
08CZ02-University Hospital Motol
08EA02-Tartu University Hospital
08FR40-Marseille Sainte Marguerite (APM) (A) - CHIRURGIE THORACIQUE
08FR41-Marseille Timone adultes (APM) (A) - CHIRURGIE CARDIAQUE
08FR42-Marseille Timone enfants (APM) (A+P) - CHIRURGIE CARDIO-VASCULAIRE
08FR43-Caen (A) - CHIRURGIE CARDIAQUE
08FR44-Dijon (A) - CHIRURGIE CARDIAQUE
08FR45-Toulouse (A) - CHIRURGIE THORACIQUE
08FR46-Toulouse (A) - CHIRURGIE CARDIO-VASCULAIRE
08FR47-Bordeaux (A+P) - UNITE DE TRANSPLANTATION CARDIAQUE
08FR48-Bordeaux (A+P) - CHIRURGIE THORACIQUE
08FR49-Montpellier (A) - UNITE DE TRANSPL. CARDIO-THORACIQUE
08FR50-Rennes (A) - CENTRE CARDIO-PNEUMOLOGIQUE
08FR51-Tours (A+P) - CHIRURGIE CARDIAQUE
08FR52-Grenoble (A) - CHIRURGIE CARDIAQUE
08FR53-Grenoble (A) - PNEUMOLOGIE
08FR54-Nantes (A+P) - CHIRURGIE CARDIO-VASCULAIRE
08FR55-Nancy (A+P) - CHIRURGIE CARDIO-PULMONAIRE
08FR56-Lille LB - CHIRURGIE THORACIQUE
08FR57-Lille (A+P) - CHIRURGIE CARDIO-VASCULAIRE
08FR58-Clermont-Ferrand (A) - CHIRURGIE CARDIAQUE
08FR59-Strasbourg (A) - CHIRURGIE THORACIQUE
08FR60-Strasbourg (A) - CHIRURGIE CARDIO-PULMONAIRE
08FR61-Lyon (A+P) - POLE DE TRANSPLANTATION PULMONAIRE
08FR62-Lyon I (HCL) (A+P) - Pole de Transplantation Cardiaque
08FR63-Lyon II (HCL) (A) - POLE DE TRANSPLANTATION CARDIAQUE
08FR64-Paris Pitié-Salpêtrière (AP-HP) (A+P) - CHIRURGIE CARDIO-VASCULAIRE
08FR65-Paris Necker Enfants Malades (AP-HP) (A+P) - CARDIOLOGIE PEDIATRIQUE
08FR66-Clichy Beaujon (AP-HP) (A) - PNEUMOLOGIE B ET TRANSPLANTATION PULMONAIRE
08FR67-Paris Bichat (AP-HP) (A) - CHIRURGIE CARDIO-VASCULAIRE
08FR68-Paris Georges Pompidou (AP-HP) (A) - TRANSPLANTATION CARDIAQUE
08FR69-Paris Georges Pompidou (AP-HP) (A+P) - TRANSPL. PULM. ET CARDIO-PULM.
08FR70-Rouen (A+P) - CHIR. THORACIQUE ET CARDIO-VASCULAIRE
08FR71-Limoges (A) - CHIRURGIE CARDIAQUE
08FR72-Suresnes Foch (A) - CHIRURGIE THORACIQUE
08FR73-Suresnes Foch (A) - CHIRURGIE CARDIO-VASCULAIRE
08FR74-Le Plessis-Robinson Marie-Lannelongue (A+P) - CHIRURGIE CARDIAQUE
08FR75-Le Plessis-Robinson Marie-Lannelongue (A+P) - CHIRURGIE THORACIQUE CARDIO-VASCULAIRE
08FR76-Créteil Henri Mondor (AP-HP) (A) - Chirurgie Cardio-Vasculaire
08FR77-Lyon (HCL)
08FR78-Lyon LG
08FR79-MARSEILLE SUD
08FR80-Marseille LO
08FR81-Marseille XO
08FR82-Marseille XS
08FR83-Nancy LA
08FR84-Nice LA
08FR85-Nice XA
08FR86-Paris Lariboisière CA
08FR87-Paris Cochin XA
08FR88-ROUEN
08FR89-ST LAURENT DU VAR
08GR02-Onassis Cardiac Surgery Center
08HU02-Hungarian Institute of Cardiology
08HU03-Heart and Vascular Center,Semmelweis University
08IT01-Ospedale San Giovanni Battista
08IT02-OSPEDALE POLICLINICO S. MATTEO
08IT02-Universita Pavia, IRCCS Policlinico S, Matteo
08IT04-Ospedale Policlinico A. Gemelli
08IT05-Istituto Di Chirurgia Generale Ed Oncologia Chirurgica
08IT06-Ospedale Pediatrico "Bambino Gesu"
08IT06-OSPEDALE PEDIATRICO BAMBINO GESU'
08IT07-Ospedale Monaldi
08IT08-Azienda Ospedaliera Universita degli Studi di Padova
08IT09-AO NIGUARDA CA' GRANDA
08IT09-Niguarda CA Granda Hospital
08IT10-Policlinico S. Orsola - Universita degli Studi
08IT10-S.ORSOLA-MALPIGHI
08IT11-Ospedali Riuniti
08IT12-Universita
08IT13-Ospedale Ferrarotto
08IT14-Ospedale San Michele
08IT15-AZIENDA OSPEDALIERA S. M. MISERICORDIA
08IT15-Azienda Ospedaliera Santa Maria della Misericordia
08IT16-University Hospital
08IT17-Ospedele San Camillo - Forlanini
08IT18-Istituto Clinico Humanitas
08IT19-Is.Me.T.T. - UPMC Italy
08IT22-OSPEDALE PAPA GIOVANNI XXIII
08IT25-AOU Città della Salute, PO S.G.Battista
08IT26-AOU Città della Salute, PO OIRM
08IT27-AOU CONSORZIALE POLICLINICO
08IT28-AZIENDA OSPEDALIERA G. BROTZU
08IT29-A.O.U. SENESE - S.M. alle SCOTTE
08IT30-AZIENDA OSPEDALIERA
08IT31-OSPEDALE CIVILE MAGGIORE
08NZ02-Auckland City Hospital
08PL01-Silesian Medical School
08PL02-Jagielionian University
08PL03-Regional Pulmonary Hospital
08PT01-Hosp de Santa Cruz
08PT02-CENTRO HOSPITALAR LISBOA OCIDENTAL
08R001-Mures Heart Center
08SP01-COMPLEJO HOSPITALARIO UNIVERSITARIO JUAN CANALEJO
08SP01-Hospital Juan Canalejo
08SP02-HOSPITAL MARQUÉS DE VALDECILLA. SANTANDER
08SP02-HOSPITAL UNIVERSITARIO MARQUES DE VALDECILLA
08SP03-HOSPITAL DE BELLVITGE. BARCELONA
08SP04-Clinica Universitaria de Navarra
08SP05-Jimenez Diaz Foundation
08SP06-HOSPITAL VIRGEN DEL ROCIO. SEVILLA
08SP07-HOSPITAL SANTA CREU I SANT PAU. BARCELONA
08SP08-HOSPITAL 12 DE OCTUBRE. MADRID
08SP08-HOSPITAL UNIVERSITARIO 12 DE OCTUBRE
08SP09-Hospital Reina Sofia
08SP09-HOSPITAL REINA SOFÍA. CÓRDOBA
08SP09-HOSPITAL UNIVERSITARIO REINA SOFIA
08SP10-HOSPITAL GREGORIO MARAÑÓN. MADRID
08SP11-Hospital La Paz
08SP12-Hospital Universitario Puerta de Hierro
08SP12-HOSPITAL UNIVERSITARIO PUERTA DE HIERRO
08SP13-HOSPITAL UNIVERSITARI I POLITÈCNIC LA FE. VALENCIA
08SP13-HOSPITAL UNIVERSITARIO LA FE
08SP14-HOSPITAL CLINIC I PROVINCIAL. BARCELONA
08SP15-HOSPITAL UNIVERSITARIO VALL D’HEBRON
08SP15-HOSPITAL VALL D´HEBRÓN. BARCELONA. Niños
08SP15-Vall D'Herbron
08SP16-Hospital Central DE Asturias
08SP19-HOSPITAL LA PAZ INFANTIL
08SP19-HOSPITAL LA PAZ. MADRID. Niños
08SP20-HOSPITAL VIRGEN DE LA ARRIXACA. MURCIA
08SP21-HOSPITAL MIGUEL SERVET. ZARAGOZA
08SP22-HOSPITAL CLÍNICO. VALLADOLID
08SZ01-Bern University Hospital
08SZ02-University Hospital (Inselspital Bern)
08SZ03-University Hospital Zurich
08SZ04-Geneva University Hospital
08SZ05-Hospital Universitaire
08SZ06-University Clinic for Cardio Thoracic Surgery Basel
08SZ07-Centre Hospitalier Universitaire Vaudois
09DN01-Skejby University Hospital
09DN02-Rigshospitalet, National University Hospital
09FI01-Helsinki University Central Hospital
09FI02-Children's Hospital, Univ of Helsinki
09NR01-Rikshospitalet - National Hospital of Norway
09SW03-Karolinska University Hospital, Solna
09SWO1-Sahlgrenska University Hospital
09SWO2-University Hospital of Lund
10AL01-St. Vincent
10AL02-Royal Children
10AL04-The Prince Charles Hospital
10AL05-The Alfred Hospital
10AL07-Royal Perth Hospital
10AL08-Fiona Stanley Hospital
ALBP-TX1-Baptist Medical Center Princeton
ALCH-TX1-Children's of Alabama
ALUA-TX1-University of Alabama Hospital
ARBH-TX1-Baptist Medical Center
ARCH-TX1-Arkansas Childrens Hospital
ARUA-TX1-The University Hospital of Arkansas
ARUA-VA1-John L. McClellan Veterans Administration Hospital
AZCH-TX1-Phoenix Children's Hospital
AZHH-TX1-Phoenix Regional Medical Center
AZMC-TX1-Mayo Clinic Hospital
AZSJ-TX1-St. Joseph's Hosp & Med Ctr
AZUA-TX1-University Medical Center, Univ of Arizona
CABM-TX1-Summit Medical Center
CACH-TX1-Rady Children's Hospital and Health Center
CACL-TX1-Childrens Hospital Los Angeles
CACS-TX1-Cedars Sinai Medical Center
CAEM-TX1-Eisenhower Memorial Hospital
CAGH-TX1-Scripps Green Hospital
CAIM-TX1-University of California Irvine Medical Center
CAKF-TX1-Kaiser Permanente Hospital
CALL-TX1-Loma Linda University Medical Center
CAMC-TX1-Mercy Hospital and Medical Center
CAPC-TX1-Lucile Salter Packard Children's Hosp
CAPM-TX1-California Pacific Medical Center
CARZ-TX1-Hoag Memorial Hospital Presbyterian
CASD-TX1-University of California San Diego Medical Center
CASF-TX1-University of California San Francisco Medical Center
CASG-TX1-Sutter Memorial Hospital
CASH-TX1-Sharp Memorial Hospital
CASM-TX1-University of California Davis Medical Center
CASU-TX1-Stanford University Medical Center
CASV-TX1-Saint Vincent Medical Center
CAUC-TX1-University of California at Los Angeles Medical Center
CAUH-TX1-University of Southern California University Hospital
COCH-TX1-The Childrens Hospital
COMH-TX1-Memorial Hospital
COPM-TX1-Centura Porter Adventist Hospital
COPV-TX1-Poudre Valley Hospital
COSL-TX1-Presbyterian St Lukes Medical Center
COUC-TX1-University Hospital University of Colorado Health Science Center
CTHH-TX1-Hartford Hospital
CTYN-TX1-Yale New Haven Hospital
DCCH-TX1-Childrens National Medical Center
DCGU-TX1-Georgetown University Medical Center
DCGW-TX1-George Washington University Medical Center and VA Medical Center
DCWH-TX1-Washington Hospital Center
DEAI-TX1-Alfred I DuPont Hospital for Children
FLAC-TX1-All Childrens Hospital
FLCC-TX1-Cleveland Clinic Florida Weston
FLFH-TX1-Florida Hospital Medical Center
FLJD-TX1-Joe DiMaggio Children's Hospital
FLJM-TX1-Jackson Memorial Hospital University of Miami School of Medicine
FLMC-TX1-Miami Childrens Hospital
FLMR-TX1-Memorial Regional Hospital
FLSJ-TX1-St Josephs Hospital
FLSL-TX1-St Lukes Hospital
FLTG-TX1-Tampa General Hospital
FLTO-TX1-Tallahassee Memorial Hospital
FLUF-TX1-Shands Hospital at The University of Florida
FLUM-TX1-University Medical Center
GAEH-TX1-Egleston Childrens Hospital at Emory University
GAEM-TX1-Emory University Hospital
GAPH-TX1-Piedmont Hospital
GASJ-TX1-Saint Josephs Hospital of Atlanta
GAUH-TX1-University Hospital
HISF-TX1-St Francis Medical Center
IAIV-TX1-University of Iowa Hospitals and Clinics and VA Medical Center of Iowa
IAIV-VA1-Iowa City VA Medical Center
IAMH-TX1-Mercy Medical Center-Des Moines
ILCH-TX1-Christ Hospital and Medical Center
ILCM-TX1-Childrens Memorial Hospital
ILEH-TX1-Evanston Hospital
ILLU-TX1-Loyola University Medical Center and Hines VA Hospital
ILLU-VA1-Hines Veterans Administration Medical Center
ILNM-TX1-Northwestern Memorial Hospital
ILPL-TX1-Rush Presbyterian St Lukes Medical Center
ILSF-TX1-OSF Saint Francis Medical Center
ILSJ-TX1-St. Johns Hospital
ILUC-TX1-University of Chicago Medical Center
ILUI-TX1-Univ of Illinois Hospital and Clinics
INIM-TX1-Riley Hospital - Indiana University Health
INIU-TX1-Indiana University Medical Center
INLH-TX1-Lutheran Hospital of Fort Wayne
INSV-TX1-St Vincent Hospital and Health Care Center
KSFT-TX1-St Francis Hospital and Medical Center
KSFW-TX1-Via Christi Regional Medical Center, St Francis Campus
KSUK-TX1-University of Kansas Medical Center
KYHH-TX1-Columbia Audubon Hospital
KYJH-TX1-Jewish Hospital
KYKC-TX1-Kosair Childrens Hospital
KYUK-TX1-University of Kentucky Medical Center
LACH-TX1-Children's Hospital
LAOF-TX1-Ochsner Foundation Hospital
LASU-TX1-Louisiana State University Medical Center Shreveport
LATU-TX1-Tulane University Medical Center
LAWK-TX1-Willis Knighton Medical Center
MACH-TX1-Children's Hospital
MAMG-TX1-Massachusetts General Hospital
MANM-TX1-New England Medical Center
MAPB-TX1-Brigham and Womens Hospital
MAUM-TX1-University of Massachusetts Memorial Medical Center
MDJH-TX1-Johns Hopkins Hospital
MDUM-TX1-University of Maryland Medical System
MDWA-TX1-Washington Adventist Hospital
MIBH-TX1-William Beaumont Hospital
MICH-TX1-Childrens Hospital of Michigan
MIHF-TX1-Henry Ford Hospital
MIHH-TX1-Harper Hospital Detroit Medical Center
MISH-TX1-Spectrum Health
MIUM-TX1-University of Michigan Medical Center
MNAC-TX1-Univ of Minn Amplatz Children's Hosp
MNAN-TX1-Abbott Northwestern Hospital
MNCM-TX1-Childrens Health Care Minneapolis
MNSM-TX1-Saint Marys Hospital
MNUM-TX1-University of Minnesota Medical Center, Fairview
MOBH-TX1-Barnes-Jewish Hospital/Washington University
MOCG-TX1-Cardinal Glennon Childrens Hospital
MOCH-TX1-St Louis Childrens Hospital at Washington University Medical Center
MOCM-TX1-Children's Mercy Hospital
MODU-TX1-DePaul Health Center
MOLH-TX1-St Lukes Hospital of Kansas City
MOMM-TX1-Menorah Medical Center
MOSL-TX1-St Louis University Hospital
MOUM-TX1-University of Missouri Hospital and Clinics
MSUM-TX1-University of Mississippi Medical Center
NCBG-TX1-North Carolina Baptist Hospital
NCCM-TX1-Carolinas Medical Center
NCDU-TX1-Duke University Medical Center and Durham VA Medical Center
NCEC-TX1-Pitt County Memorial Hospital, East Carolina University School of Medicine
NCMH-TX1-University of North Carolina Hospitals
NEBM-TX1-BryanLGH Medical Center East
NECH-TX1-Children's Hospital & Medical Center
NECM-TX1-Nebraska Health System Clarkson Hospital
NESJ-TX1-Saint Joseph Hospital at Creighton University Medical Center
NEUN-TX1-Nebraska Health System
NJBI-TX1-Newark Beth Israel Medical Center
NJRW-TX1-Robert Wood Johnson University Hospital
NMPH-TX1-Presbyterian Hospital
NYAM-TX1-Albany Medical Center Hospital
NYBC-TX1-Childrens Hospital of Buffalo
NYBU-TX1-Buffalo General Hospital, Children's Hospital, & Buffalo VA Medical Center
NYBU-VA1-Buffalo Veterans Administration Medical Center
NYCP-TX1-The Presbyterian Hospital in New York City/Columbia Presbyterian Med Ctr
NYDS-TX1-State University of New York Health Science Center at Brooklyn
NYFL-TX1-Strong Memorial Hospital, University of Rochester School of Medicine
NYMA-TX1-Montefiore Medical Center
NYMS-TX1-Mount Sinai Medical Center
NYNY-TX1-The New York Hospital
NYUC-TX1-New York University Medical Center
NYWC-TX1-Westchester Medical Center
OHCC-TX1-The Cleveland Clinic Foundation
OHCH-TX1-Children's Hospital
OHCM-TX1-Childrens Hospital Medical Center
OHCO-TX1-Medical College Hospitals
OHOU-TX1-Ohio State University Hospital
OHUC-TX1-University of Cincinnati Medical Center University Hospital
OHUH-TX1-University Hospitals of Cleveland
OKBC-TX1-Integris Baptist Medical Center
OKCM-TX1-Childrens Hospital of Oklahoma
OKMD-TX1-University Hospital
OKSA-TX1-St Anthony Hospital
OKSF-TX1-Saint Francis Hospital
ORGS-TX1-Legacy Good Samaritan Hospital and Medical Center
ORPM-TX1-Providence Portland Medical Center
ORSV-TX1-St Vincent Hospital and Medical Center
ORUO-TX1-Oregon Health Sciences University Hospital and Portland VA Medical Center
PAAG-TX1-Allegheny General Hospital
PACH-TX1-Childrens Hospital of Pittsburgh
PACP-TX1-Children's Hospital of Philadelphia
PAHE-TX1-Milton S Hershey Medical Center
PAHM-TX1-Hahnemann University Hospital Tenet
PALH-TX1-The Lankenau Hospital
PAPT-TX1-University of Pittsburgh Medical Center and Oakland VA Medical Center
PASC-TX1-St Christophers Hospital for Children
PATJ-TX1-Thomas Jefferson University Hospital
PATU-TX1-Temple University Hospital
PAUP-TX1-Hospital of the University of Pennsylvania
PRCC-TX1-Cardiovascular Center of Puerto Rico and the Caribbean
SCMU-TX1-Medical University of South Carolina
SCPH-TX1-Providence Hospital
TNBM-TX1-Baptist Memorial Hospital
TNLB-TX1-Le Bonheur Childrens Medical Center
TNMH-TX1-Methodist Hospital of Memphis
TNST-TX1-Saint Thomas Hospital
TNVU-TX1-Vanderbilt University Medical Center and Nashville VA Medical Center
TNVU-VA1-Nashville Veterans Administration Hospital
TXBA-TX1-Brooke Army Medical Center
TXBC-TX1-University Hospital University of Texas Health Science Center
TXCM-TX1-Childrens Medical Center of Dallas
TXCT-TX1-Seton Medical Center
TXHD-TX1-Columbia Hospital at Medical City Dallas
TXHH-TX1-Hermann Hospital University of Texas at Houston
TXHI-TX1-St Lukes Episcopal Hospital
TXHS-TX1-Methodist Specialty & Transplant Hospital
TXJS-TX1-University of Texas Medical Branch at Galveston
TXLM-TX1-Covenant Medical Center
TXMC-TX1-Methodist Medical Center Dallas
TXMH-TX1-The Methodist Hospital Baylor College of Medicine
TXRM-TX1-Christus Santa Rosa Medical Center
TXSP-TX1-St Paul Medical Center University of Texas Southwestern
TXSW-TX1-Scott and White Memorial Hospital
TXTC-TX1-Texas Childrens Hospital
TXTX-TX1-Baylor University Medical Center
TXWH-TX1-Wilford Hall Medical Center
UNKN-TX1-Unknown Hospital
UNOS-UNOS_Employees
UNOS-UNS-ISHLT - For Demonstration
UTLD-TX1-LDS Hospital
UTMC-TX1-University of Utah Medical Center and Salt Lake City VA Medical Center
UTMC-VA1-Salt Lake City Veterans Administation Medical Center
UTPC-TX1-Primary Childrens Medical Center
VACH-TX1-Childrens Hospital of the Kings Daughters
VAFH-TX1-Inova Fairfax Hospital
VAHD-TX1-Henrico Doctors Hospital
VAMC-TX1-Medical College of Virginia Hospitals
VAMV-TX1-Hunter Holmes McGuire Veterans Administration Medical Center
VANG-TX1-Sentara Norfolk General Hospital
VAUV-TX1-University of Virginia Health Sciences Center
WACH-TX1-Childrens Hospital Medical Center
WASH-TX1-Sacred Heart Medical Center
WAUW-TX1-University of Washington Medical Center
WAVM-TX1-Virginia Mason Medical Center
WICH-TX1-Childrens Hospital of Wisconsin
WIMC-TX1-John L Doyne Hospital and Zalocki Veterans Administration Medical Center
WISE-TX1-Froedtert Memorial Lutheran Hospital
WISE-VA1-Zablocki Veterans Administration Medical Center
WISL-TX1-St. Luke's Medical Center
WIUW-TX1-University of Wisconsin Hospital and Clinics
ZZZZ-TX1-Non-UNOS Member US Hospital
TIER 1 ONLY
Patient Status:
Living
Dead
Retransplanted
Lost
Primary Cause of Death:
UNKNOWN
OTHER SPECIFY
GRAFT FAILURE: PRIMARY FAILURE
GRAFT FAILURE: REJECTION- HYPERACUTE
GRAFT FAILURE: REJECTION- ACUTE
GRAFT FAILURE: REJECTION- CHRONIC
GRAFT FAILURE: TECHNICAL
GRAFT FAILURE: GRAFT INFECTION
GRAFT FAILURE: RECURRENT DISEASE
GRAFT FAILURE: NON-SPECIFIC
INFECTION: BACTERIAL SEPTICEMIA
INFECTION: BACTERIAL PNEUMONIA
INFECTION: BACTERIAL- OTHER SPECIFY
INFECTION: VIRAL- CYTOMEGALOVIRUS (CMV)
INFECTION: VIRAL- HEPATITIS
INFECTION: VIRAL-SEPTICEMIA
INFECTION: VIRAL- OTHER SPECIFY
INFECTION: FUNGAL- ASPERGILLUS
INFECTION: FUNGAL- OTHER SPECIFY
INFECTION: PROTOZOAL
INFECTION: MIXED OTHER SPECIFY
INFECTION: OTHER SPECIFY
CARDIOVASCULAR: MYOCARDIAL INFARCTION
CARDIOVASCULAR: CARDIAC ARREST
CARDIOVASCULAR: ARTERIAL EMBOLISM
CARDIOVASCULAR: VENTRICULAR FAILURE
CARDIOVASCULAR: CORONARY ARTERY DISEASE
CARDIOVASCULAR: ATHEROSCLEROSIS
CARDIOVASCULAR: RHYTHM DISORDER
CARDIOVASCULAR: CARDITIS
CARDIOVASCULAR: AORTIC ANEURYSM
CARDIOVASCULAR: CARDIOGENIC SHOCK
CARDIOVASCULAR: OTHER SPECIFY
PULM: DEHISCENCE
PULM: BRONCHIOLITIS
PULM: PRIMARY PULMONARY HYPERTENSION
PULM: PULMONARY EMBOLISM
PULM: RESPIRATORY FAILURE
PULM: ACUTE RESPIRATORY DISTRESS DISEASE
PULM: OTHER SPECIFY
CEREBROVASCULAR: STROKE
CEREBROVASCULAR: HEMORRHAGE (NON-STROKE)
CEREBROVASCULAR: BRAIN ANOXIA
CEREBROVASCULAR: DEGENERATIVE BRAIN DISEASE
CEREBROVASCULAR: OTHER SPECIFY
HEMORRHAGE: GASTROINTESTINAL
HEMORRHAGE: INTRAOPERATIVE
HEMORRHAGE: DISSEMINATED INTRAVAS COAGULATION
HEMORRHAGE: POST-OPERATIVE
HEMORRHAGE: RESPIRATORY
HEMORRHAGE: OTHER SPECIFY
MALIG: METASTATIC OTHER SPECIFY
MALIG: PRIMARY OTHER SPECIFY
MALIG: POST-TX LYMPHOPROLIFERATIVE DISORDER
MALIG: LYMPHOMA
MALIG: SKIN
MALIG: OTHER SPECIFY
DIABETES MELLITUS
INTRAOP: NOT HEMORRHAGE - OTHER SPECIFY
PANCREATITIS
RENAL FAILURE
LIVER FAILURE
MULTIPLE ORGAN FAILURE
FLUID/ELECTROLYTE DISORDER
ACID/BASE DISORDER
AMYLOIDOSIS
HEMATOLOGIC OTHER SPECIFY
IMMUNOSUPPRESSIVE DRUG RELATED - HEMATOLOGIC
IMMUNOSUPPRESSIVE DRUG RELATED - NON-HEMATOLOGIC
NON-IMMUNO DRUG RELATED - HEMATOLOGIC
NON-IMMUNO - NON-HEMATOLOGIC, SPECIFY DRUG
MOTOR VEHICLE ACCIDENT
SUICIDE
NON-COMPLIANCE
TRAUMA OTHER SPECIFY
Specify:
Date: Last Seen, Retransplanted or Death:
Indicates required field.
Contributory Cause of Death:
UNKNOWN
OTHER SPECIFY
GRAFT FAILURE: PRIMARY FAILURE
GRAFT FAILURE: REJECTION- HYPERACUTE
GRAFT FAILURE: REJECTION- ACUTE
GRAFT FAILURE: REJECTION- CHRONIC
GRAFT FAILURE: TECHNICAL
GRAFT FAILURE: GRAFT INFECTION
GRAFT FAILURE: RECURRENT DISEASE
GRAFT FAILURE: NON-SPECIFIC
INFECTION: BACTERIAL SEPTICEMIA
INFECTION: BACTERIAL PNEUMONIA
INFECTION: BACTERIAL- OTHER SPECIFY
INFECTION: VIRAL- CYTOMEGALOVIRUS (CMV)
INFECTION: VIRAL- HEPATITIS
INFECTION: VIRAL-SEPTICEMIA
INFECTION: VIRAL- OTHER SPECIFY
INFECTION: FUNGAL- ASPERGILLUS
INFECTION: FUNGAL- OTHER SPECIFY
INFECTION: PROTOZOAL
INFECTION: MIXED OTHER SPECIFY
INFECTION: OTHER SPECIFY
CARDIOVASCULAR: MYOCARDIAL INFARCTION
CARDIOVASCULAR: CARDIAC ARREST
CARDIOVASCULAR: ARTERIAL EMBOLISM
CARDIOVASCULAR: VENTRICULAR FAILURE
CARDIOVASCULAR: CORONARY ARTERY DISEASE
CARDIOVASCULAR: ATHEROSCLEROSIS
CARDIOVASCULAR: RHYTHM DISORDER
CARDIOVASCULAR: CARDITIS
CARDIOVASCULAR: AORTIC ANEURYSM
CARDIOVASCULAR: CARDIOGENIC SHOCK
CARDIOVASCULAR: OTHER SPECIFY
PULM: DEHISCENCE
PULM: BRONCHIOLITIS
PULM: PRIMARY PULMONARY HYPERTENSION
PULM: PULMONARY EMBOLISM
PULM: RESPIRATORY FAILURE
PULM: ACUTE RESPIRATORY DISTRESS DISEASE
PULM: OTHER SPECIFY
CEREBROVASCULAR: STROKE
CEREBROVASCULAR: HEMORRHAGE (NON-STROKE)
CEREBROVASCULAR: BRAIN ANOXIA
CEREBROVASCULAR: DEGENERATIVE BRAIN DISEASE
CEREBROVASCULAR: OTHER SPECIFY
HEMORRHAGE: GASTROINTESTINAL
HEMORRHAGE: INTRAOPERATIVE
HEMORRHAGE: DISSEMINATED INTRAVAS COAGULATION
HEMORRHAGE: POST-OPERATIVE
HEMORRHAGE: RESPIRATORY
HEMORRHAGE: OTHER SPECIFY
MALIG: METASTATIC OTHER SPECIFY
MALIG: PRIMARY OTHER SPECIFY
MALIG: POST-TX LYMPHOPROLIFERATIVE DISORDER
MALIG: LYMPHOMA
MALIG: SKIN
MALIG: OTHER SPECIFY
DIABETES MELLITUS
INTRAOP: NOT HEMORRHAGE - OTHER SPECIFY
PANCREATITIS
RENAL FAILURE
LIVER FAILURE
MULTIPLE ORGAN FAILURE
FLUID/ELECTROLYTE DISORDER
ACID/BASE DISORDER
AMYLOIDOSIS
HEMATOLOGIC OTHER SPECIFY
IMMUNOSUPPRESSIVE DRUG RELATED - HEMATOLOGIC
IMMUNOSUPPRESSIVE DRUG RELATED - NON-HEMATOLOGIC
NON-IMMUNO DRUG RELATED - HEMATOLOGIC
NON-IMMUNO - NON-HEMATOLOGIC, SPECIFY DRUG
MOTOR VEHICLE ACCIDENT
SUICIDE
NON-COMPLIANCE
TRAUMA OTHER SPECIFY
Specify:
Contributory Cause of Death:
UNKNOWN
OTHER SPECIFY
GRAFT FAILURE: PRIMARY FAILURE
GRAFT FAILURE: REJECTION- HYPERACUTE
GRAFT FAILURE: REJECTION- ACUTE
GRAFT FAILURE: REJECTION- CHRONIC
GRAFT FAILURE: TECHNICAL
GRAFT FAILURE: GRAFT INFECTION
GRAFT FAILURE: RECURRENT DISEASE
GRAFT FAILURE: NON-SPECIFIC
INFECTION: BACTERIAL SEPTICEMIA
INFECTION: BACTERIAL PNEUMONIA
INFECTION: BACTERIAL- OTHER SPECIFY
INFECTION: VIRAL- CYTOMEGALOVIRUS (CMV)
INFECTION: VIRAL- HEPATITIS
INFECTION: VIRAL-SEPTICEMIA
INFECTION: VIRAL- OTHER SPECIFY
INFECTION: FUNGAL- ASPERGILLUS
INFECTION: FUNGAL- OTHER SPECIFY
INFECTION: PROTOZOAL
INFECTION: MIXED OTHER SPECIFY
INFECTION: OTHER SPECIFY
CARDIOVASCULAR: MYOCARDIAL INFARCTION
CARDIOVASCULAR: CARDIAC ARREST
CARDIOVASCULAR: ARTERIAL EMBOLISM
CARDIOVASCULAR: VENTRICULAR FAILURE
CARDIOVASCULAR: CORONARY ARTERY DISEASE
CARDIOVASCULAR: ATHEROSCLEROSIS
CARDIOVASCULAR: RHYTHM DISORDER
CARDIOVASCULAR: CARDITIS
CARDIOVASCULAR: AORTIC ANEURYSM
CARDIOVASCULAR: CARDIOGENIC SHOCK
CARDIOVASCULAR: OTHER SPECIFY
PULM: DEHISCENCE
PULM: BRONCHIOLITIS
PULM: PRIMARY PULMONARY HYPERTENSION
PULM: PULMONARY EMBOLISM
PULM: RESPIRATORY FAILURE
PULM: ACUTE RESPIRATORY DISTRESS DISEASE
PULM: OTHER SPECIFY
CEREBROVASCULAR: STROKE
CEREBROVASCULAR: HEMORRHAGE (NON-STROKE)
CEREBROVASCULAR: BRAIN ANOXIA
CEREBROVASCULAR: DEGENERATIVE BRAIN DISEASE
CEREBROVASCULAR: OTHER SPECIFY
HEMORRHAGE: GASTROINTESTINAL
HEMORRHAGE: INTRAOPERATIVE
HEMORRHAGE: DISSEMINATED INTRAVAS COAGULATION
HEMORRHAGE: POST-OPERATIVE
HEMORRHAGE: RESPIRATORY
HEMORRHAGE: OTHER SPECIFY
MALIG: METASTATIC OTHER SPECIFY
MALIG: PRIMARY OTHER SPECIFY
MALIG: POST-TX LYMPHOPROLIFERATIVE DISORDER
MALIG: LYMPHOMA
MALIG: SKIN
MALIG: OTHER SPECIFY
DIABETES MELLITUS
INTRAOP: NOT HEMORRHAGE - OTHER SPECIFY
PANCREATITIS
RENAL FAILURE
LIVER FAILURE
MULTIPLE ORGAN FAILURE
FLUID/ELECTROLYTE DISORDER
ACID/BASE DISORDER
AMYLOIDOSIS
HEMATOLOGIC OTHER SPECIFY
IMMUNOSUPPRESSIVE DRUG RELATED - HEMATOLOGIC
IMMUNOSUPPRESSIVE DRUG RELATED - NON-HEMATOLOGIC
NON-IMMUNO DRUG RELATED - HEMATOLOGIC
NON-IMMUNO - NON-HEMATOLOGIC, SPECIFY DRUG
MOTOR VEHICLE ACCIDENT
SUICIDE
NON-COMPLIANCE
TRAUMA OTHER SPECIFY
Specify:
Has the patient been hospitalized since the last patient status date:
YES
NO
UNK
Number of Hospitalizations:
Hospitalized for Rejection:
YES
NO
UNK
Hospitalized for Infection:
YES
NO
UNK
Was there evidence of noncompliance with immunosuppression medication during this follow-up period that compromised the patient's recovery:
YES
NO
UNK
Functional Status:
100% - Normal, no complaints, no evidence of disease
90% - Able to carry on normal activity: minor symptoms of disease
80% - Normal activity with effort: some symptoms of disease
70% - Cares for self: unable to carry on normal activity or active work
60% - Requires occasional assistance but is able to care for needs
50% - Requires considerable assistance and frequent medical care
40% - Disabled: requires special care and assistance
30% - Severely disabled: hospitalization is indicated, death not imminent
20% - Very sick, hospitalization necessary: active treatment necessary
10% - Moribund, fatal processes progressing rapidly
Physical Capacity:
No Limitations
Limited Mobility
Wheelchair bound or more limited
Not Applicable (< 1 year old or hospitalized)
Unknown
Working for income:
YES
NO
UNK
If No, Not Working Due To:
Disability
Demands of Treatment
Insurance Conflict
Inability to Find Work
Patient Choice - Homemaker
Patient Choice - Student Full Time/Part Time
Patient Choice - Retired
Patient Choice - Other
Not Applicable - Hospitalized
Unknown
If Yes:
Working Full Time
Working Part Time due to Demands of Treatment
Working Part Time due to Disability
Working Part Time due to Insurance Conflict
Working Part Time due to Inability to Find Full Time Work
Working Part Time due to Patient Choice
Working Part Time Reason Unknown
Working, Part Time vs. Full Time Unknown
Academic Progress:
Within One Grade Level of Peers
Delayed Grade Level
Special Education
Not Applicable < 5 years old/ High School graduate or GED
Status Unknown
Academic Activity Level:
Full academic load
Reduced academic load
Unable to participate in academics due to disease or condition
Not Applicable < 5 years old/ High School graduate or GED
Status Unknown
Cognitive Development:
Definite Cognitive delay/impairment
Probable Cognitive delay/impairment
Questionable Cognitive delay/impairment
No Cognitive delay/impairment
Not Assessed
Motor Development:
Definite Motor delay/impairment
Probable Motor delay/impairment
Questionable Motor delay/impairment
No Motor delay/impairment
Not Assessed
Date of Measurement:
Height:
cm
Weight:
kg
BMI:
Graft Status:
Functioning
Failed
Primary Cause of Graft Failure:
Primary Non-Function
Acute Rejection
Chronic Rejection/Atherosclerosis
Other, Specify
Specify:
Heart:
Ejection Fraction:
%
Shortening Fraction:
%
Pacemaker:
YES
NO
UNK
Coronary Artery Disease:
YES
NO
UNK
Clinically Significant Events:
YES
NO
UNK
Lung:
FeV1:
%
O2 Requirement at Rest:
L/min
Bronchiolitis Obliterans Syndrome:
NO BOS
Yes, Grade OP
Yes, Grade 1
Yes, Grade 2
Yes, Grade 3
Yes, Grade UNK
Unknown
Bronchial Stricture (Since last follow-up):
YES
NO
UNK
If yes, Stent:
YES
NO
UNK
Did patient have any acute rejection episodes during the follow-up period:
Yes, at least one episode treated with anti-rejection agent
Yes, none treated with additional anti-rejection agent
No
Unknown
Was biopsy done to confirm acute rejection:
Biopsy not done
Yes, rejection confirmed
Yes, rejection not confirmed
Unknown
Viral Detection:
Have any of the following viruses ever been tested for: (HIV, CMV, HBV, HCV, EBV):
YES
NO
HIV:
YES
NO
Was there clinical disease (ARC, AIDS):
YES
NO
UNK
Antibody:
Positive
Negative
Not Done
UNK/Cannot Disclose
RNA:
Positive
Negative
Not Done
UNK/Cannot Disclose
CMV:
YES
NO
Was there clinical disease:
YES
NO
UNK
IgG:
Positive
Negative
Not Done
UNK/Cannot Disclose
IgM:
Positive
Negative
Not Done
UNK/Cannot Disclose
Nucleic Acid Testing:
Positive
Negative
Not Done
UNK/Cannot Disclose
Culture:
Positive
Negative
Not Done
UNK/Cannot Disclose
HBV:
YES
NO
Was there clinical disease:
YES
NO
UNK
Liver Histology:
Positive
Negative
Not Done
UNK/Cannot Disclose
Core Antibody:
Positive
Negative
Not Done
UNK/Cannot Disclose
Surface Antigen:
Positive
Negative
Not Done
UNK/Cannot Disclose
HBV DNA:
Positive
Negative
Not Done
UNK/Cannot Disclose
HCV:
YES
NO
Was there clinical disease:
YES
NO
UNK
Liver Histology:
Positive
Negative
Not Done
UNK/Cannot Disclose
Antibody:
Positive
Negative
Not Done
UNK/Cannot Disclose
RIBA:
Positive
Negative
Not Done
UNK/Cannot Disclose
HCV RNA:
Positive
Negative
Not Done
UNK/Cannot Disclose
EBV:
YES
NO
Was there clinical disease:
YES
NO
UNK
IgG:
Positive
Negative
Not Done
UNK/Cannot Disclose
EBV DNA:
Positive
Negative
Not Done
UNK/Cannot Disclose
IgM:
Positive
Negative
Not Done
UNK/Cannot Disclose
Drug Treated Hyperlipidemia:
YES
NO
UNK
Bone Disease (Symptomatic):
YES
NO
UNK
Chronic Liver Disease:
YES
NO
UNK
Cataracts:
YES
NO
UNK
Diabetes:
YES
NO
UNK
Diabetes: If Yes, Insulin Dependent:
YES
NO
UNK
Renal Dysfunction:
YES
NO
UNK
If Yes, Creatinine > 2.5 mg/dl:
YES
NO
UNK
Chronic Dialysis:
YES
NO
UNK
Renal Tx since Thoracis Tx:
YES
NO
UNK
Stroke:
YES
NO
UNK
Drug Treated Hypertension:
YES
NO
UNK
Postransplant Malignancy:
YES
NO
UNK
Donor Related:
YES
NO
UNK
Recurrence of Pre-Tx Tumor:
YES
NO
UNK
De Novo Solid Tumor:
YES
NO
UNK
De Novo Solid Tumor Type(s):
Skin, squamous cell
Skin, basal cell
Skin, melanoma
Kaposi's sarcoma: cutaneous
Kaposi's sarcoma: visceral
Brain
Renal carcinoma
Carcinoma of vulva, perineum or penis, scrotum
Carcinoma of the uterus
Ovarian
Testicular
Esophagus
Stomach
Small Intestine
Pancreas
Larynx
Tongue, throat
Thyroid
Bladder
Breast
Prostate
Colo-rectal
Primary Hepatic tumor
Metastic Liver tumor
Lung
Leukemia
Sarcomas
Other Cancers
Primary Unknown
Other Cancers Specify:
De Novo Lymphoproliferative disease and Lymphoma:
YES
NO
UNK
Biological or Anti-viral therapy:
YES
NO
Unknown/Cannot disclose
If Yes, check all that apply:
Acyclovir (Zovirax)
Cytogam (CMV)
Gamimune
Gammagard
Ganciclovir (Cytovene)
Valgancyclovir (Valcyte)
HBIG (Hepatitis B Immune Globulin)
Flu Vaccine (Influenza Virus)
Lamivudine (Epivir) (for treatment of Hepatitis B)
Other, Specify
Valacyclovir (Valtrex)
Specify:
Specify:
Other therapies:
YES
NO
If Yes, check all that apply:
Photopheresis
Plasmapheresis
Total Lymphoid Irradiation (TLI)
Were any medications given during the follow-up period for maintenance:
Yes, same as previous Followup
Yes, but different than previous Followup
None given
Yes, same as Registration
Did the physician discontinue all maintenance immunosuppressive medications:
YES
NO
Did the patient participate in any clinical research protocol for immunosuppressive medications:
YES
NO
Specify Medications
Immunosuppressive Medications at Followup
Prev Maint
Curr Maint
AR
Immunosuppressive Medications
Steroids (prednisone, methylprednisolone, Solumedrol, Medrol)
Other Immunosuppressive Medications
Atgam
Campath (alemtuzumab)
Cytoxan (cyclophosphamide)
Methotrexate (Folex PFS, Mexate-AQ, Rheumatrex)
Rituxan (rituximab)
Simulect (basiliximab)
Thymoglobulin
Investigational Immunosuppressive Medications
- Gengraf
- Neoral
- Sandimmune
- Generic cyclosporine
Imuran (azathioprine, AZA)
Leflunomide (LFL)
- CellCept (MMF)
- Generic MMF (generic CellCept)
- Myfortic (mycophenolic acid)
- Generic Myfortic (generic mycophenolic acid)
- Rapamune (sirolimus)
- Generic sirolimus
- Zortress (everolimus)
Nulojix (belatacept)
- Astagraf XL (extended release tacrolimus)
- Envarsus XR (tacrolimus XR)
- Prograf (tacrolimus)
- Generic tacrolimus (generic Prograf)
Investigational Immunosuppressive Medications
Other immunosuppressive medication, specify:
Other immunosuppressive medication, specify:
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