NZ A DATA
AUSTRALIA AND NEW ZEALAND ORGAN DONATION REGISTRY
28. Enrolled with Organ A=Not Accessed S=Not Applicable 31. Donor Coordinator 1. DONOR NUMBER 6. GENDER 7. HEIGHT (cms) 8. WEIGHT (kg) 14. DIABETES Contact with Donor Registry R=Not Registered Y=Yes Donor Family
T = Type I (Insulin dependent)P = Type II (Non insulin or insulin requiring)
29. Driver’s Licence 32. Coroner’s Case 2. WAS DONOR 9. RACIAL / ETHNIC ORIGIN A = ACTUAL 15. PAST HISTORY OF TREATED HYPERTENSION 33. Authority for B = INTENDED 30. Sought By (Refer Codes) Research 3. HOSPITAL AND STATE 10. RELIGION Organs / Tissue AUTHORITY 16. SMOKING ORGANS / TISSUES OTHER REASON OBTAINED Y/N 4. DATE OF BIRTH 11. OCCUPATION (Write In) 13. HEART 17. PAST HISTORY OF CANCER 5. POSTCODE OF DONOR 12. PRIMARY CAUSE OF DEATH BEATING Y/N If Yes, enter the separate cancer form
18. KEY EVENTS Cardio/Pulmonary Resuscitation Admission to Hospital Ventilation
35. ORGANS / TISSUES RETRIEVED (Refer Codes)
Withdrawal (DCD) SOLUTION IN ORGAN PRESERVATION RETRIEVAL ORGANS / TISSUES OTHER REASON AT STORAGE Brain Death (2nd test) Cross Clamp or
21. DONOR MAINTENANCE (POST BRAIN DEATH OR PRE-DCD) HOSPITAL REGISTRY Admission Terminal ORGANS / TISSUES AND STATE RECIPIENT SURNAME GIVEN NAME OPERATION Arterial
Oliguria in last 12 hours <20 mls / hr
Blood Gas Y=Yes N=No Updated January 2008 INSTRUCTIONS FOR COMPLETION
If maintenance drugs given post brain death
OF DONOR SHEET Terminal = In Intensive Care Unit (ICU)
4 = Prior family request 9 = Family refusal
State prefix, then number (eg. Q00001, N00023,
Mean Arterial Blood Pressure (MAP) <50 mm Hg
15 = Other Road Accident (Specify) 21 = Fall
Enter Y=Yes or N=No (If Yes, enter duration)
If authority obtained enter Y in box–If not enter N
22 = Other Accident (Specify) (Specify)
31 = Spontaneous Subarachnoid Haemorrhage
Complete only for organs where authority
32 = Other Spontaneous Intracranial Haemorrhage
obtained (If not retrieved – enter reason)
23. KIDNEY DONOR Enter Y=Yes or N=No in box
A=Actual
10 = No suitable recipient 18 = Inotropic support
34 = Hypoxia (Specify)
If not all information known, enter X in box
A person from whom the retrieval operation is
35 = Cerebral Oedema (Specify)
commenced for the purpose of transplantation.
Admission = First available result
40 = Cerebral Tumour (Specify benign or malignant) If malignant–enter cancer sheet with details Terminal = In Intensive Care Unit (ICU)
medically unsuitable at time of surgery or after
51 = Sudden Infant Death Syndrome (SIDS)
B=Intended
A person from whom authority has been given or
volunteered, but organ donation did not proceed.
60 = Other (Specify) Urine Output = last hour in ICU preceding transfer
(eg positive virology, cardiac arrest, further
PRESERVATION (Solution in organ at storage)
investigations discovered cancer, infection etc)
Oliguria In last 12 hours Record in order of solutions given Record reason in Section 20 or 35 If two solutions used (eg Ross followed by UW)
As documented in Medical Records and /or
Enter most recent donor values prior to retrieval
discussion with the Local Medical Officer
10 = No washout (Ice slush only) 20 = Citrate solution (Ross)
If a hospital is not on the list, write on the sheet and
ECG Normal Y=Yes or N=No Do not use code that is used by the tissue typing Echocardiogram Y=Yes or N=No laboratory for allocation
Y=Yes N=No U=Unknown If Yes, please enter the separate cancer form
Two digits per box = DD.MM.YY (eg 03.04.80)
52 = Albumin based blood cardioplegia (pneumoplegia)
Admission to Hospital=Initial admission to hospital Bronchoscopy
When a patient is transferred record admission time
Postal residential address of donor. Enter 9999
if overseas resident temporarily in Australia or NZ
Do not use gases taken to determine brain death Ventilation=Time of Intubation Chest Trauma Withdrawal (DCD)=Date and time of withdrawal
1=Pneumothorax 2=Chest Drain 3=Other (Specify)
95 = PFC (Perfluorodecalin)–UW (Islets Storage)
Record time of Second Brain Death Test and Cross Clamp of Aorta in Operating Theatre
Enter to nearest centimetre (eg 160.5 = 161)
27. PANCREAS DONOR Enter Y=Yes or N=No in box
If Brain Death NOT CERTIFIED (Donation After
Code as per ANZDATA Hospital List. See Question 3
Cardiac Death (DCD) record time of cardiac death
Enter to nearest kilogram (eg 80.6 = 81)
and commencement of adequate cold perfusion Hospital and State –
Code as per ANZDATA hospital list. See Question 3
Blood Group Enter Transplant Hospital NOT Caring Hospital (Enter subtypes A1 or A2 if known) Tissue Typing
20. HEPATITIS HBV sAg, HBV CORE ANTIBODY,
HCV Ab, HCV NAT (Nucleic Acid), CMV IgG,
N = Not used (Specify reason in Surname section)
U = Unusable (Specify reason in Surname section)
OTHER – Any other virology tests performed eg
IMPORTANT for all solid organs Enter 1=Positive 2=Negative 3=Not Done
Bayerischer Gewichtheber- und Kraftsportverband e.V. Sport Gewichtheben Inhalt der Anlagen (Regelwerke, Listen, Formulare, Broschüren) Mit vorliegenden Arbeitsmappe Anti-Doping-Belehrung, sollen Trainer und Verantwortliche auf Vereinsebene, in die Lage versetzt werden, mit Ihren Athleten eine ordnungsgemäße Anti-Doping-Belehrung durchzuführen. Die Arbeitsmappe Anti-Doping-Belehrung d
Strengthening Your Immune System: Part 1 First the bad news: there is no immune system! Now the good news: the immune function in human beings is scattered all throughout the body. Your ability to resist illness and/or stay healthy is a function of ALL of you--- your whole bodymind. We are miraculous beings with multiple strategies and faculties for combating toxins and staying well.
NZ