STANDARD DATA DICTIONARY #139.5 -- SURGERY TRANSPLANT ASSESSMENTS FILE                                            3/24/25    PAGE 1
STORED IN ^SRT(  *** NO DATA STORED YET ***   SITE: WWW.BMIRWIN.COM   UCI: VISTA,VISTA                             (VERSION 3.0)   

DATA          NAME                  GLOBAL        DATA
ELEMENT       TITLE                 LOCATION      TYPE
-----------------------------------------------------------------------------------------------------------------------------------
This file contains the organ transplant procedures performed within VHA facilities, as well as outside the VHA.  


              DD ACCESS: @
              RD ACCESS: @
              WR ACCESS: @
             DEL ACCESS: @
           LAYGO ACCESS: @
           AUDIT ACCESS: @

CROSS
REFERENCED BY: DATE OF TRANSPLANT(AC), DATE OF TRANSPLANT(ADT), DATE OF LAST TRANSMISSION(AT), PATIENT(B)

INDEXED BY:    WARM ISCHEMIA TIME FOR ORGAN & COLD ISCHEMIA TIME FOR ORGAN (AD), VACO ID & PATIENT (AE), TRANSPLANT TYPE &
               ASSESSMENT STATUS & PATIENT (AF), DONOR DATE OF BIRTH (AGE)




139.5,.01     PATIENT                0;1 POINTER TO PATIENT FILE (#2) (Required)

              Patient's Name   
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the name of the patient. 
              DESCRIPTION:
                                This is the name of the patient.  

              CROSS-REFERENCE:  139.5^B 
                                1)= S ^SRT("B",$E(X,1,30),DA)=""
                                2)= K ^SRT("B",$E(X,1,30),DA)

              RECORD INDEXES:   AE (#548), AF (#549)

139.5,1       DATE OF TRANSPLANT     0;2 DATE (Required)

              Date of Transplant   
              INPUT TRANSFORM:  S %DT="EP" D ^%DT S X=Y K:X<1 X
              LAST EDITED:      SEP 29, 2008 
              HELP-PROMPT:      Enter Date of Transplant. 
              DESCRIPTION:
                                Indicate date organ transplant was completed.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER

              CROSS-REFERENCE:  139.5^ADT^MUMPS 
                                1)= D ADT^SRTPUTL
                                2)= D KADT^SRTPUTL
                                The ADT cross reference on the TRANSPLANT DATE field uses the 'inverse' date/time format to sort
                                and to display cases by inverse chronological order.                            


              CROSS-REFERENCE:  139.5^AC^MUMPS 
                                1)= S ^SRT("AC",X,DA)=$P(^SRT(DA,0),"^")
                                2)= K ^SRT("AC",X,DA)
                                The AC cross reference on the DATE OF TRANSPLANT field is used to sort entries by date of
                                transplant for reports.  



139.5,2       SURGERY CASE           0;3 POINTER TO SURGERY FILE (#130)

              Surgery Case   
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the matching case in the SURGERY file (#130). 
              DESCRIPTION:      This is the case in the SURGERY file associated with this file entry.  This field is entered if the
                                transplant was done in a VA medical center. This field will remain blank if the transplant was done
                                in a non-VA facility.  

              WRITE AUTHORITY:  ^
              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,3       VACO ID                .01;11 NUMBER (Required)

              VACO ID    
              INPUT TRANSFORM:  K:+X'=X!(X>999999)!(X<1)!(X?.E1"."1N.N) X D:$D(X) CHK^SRTPNEW
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the VACO ID number provided by VA Central Office. 
              DESCRIPTION:      The VACO ID is a unique identifier provided centrally for each patient undergoing a transplant. 
                                This field is required for creating a Transplant Assessment.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER

              RECORD INDEXES:   AE (#548)

139.5,4       RECIPIENT HEIGHT       0;4 FREE TEXT

              Recipient Height   
              INPUT TRANSFORM:  S:X="NS"!(X="ns") X="NS" Q:X="NS"  K:+X>300!(+X<0) X D H^SROAMEAS
              OUTPUT TRANSFORM: S Y=$S(Y="NS":"NO STUDY",Y["C":+Y_" CM.",+Y:Y_" INCHES",1:Y)
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter Recipient height. 
              DESCRIPTION:      Indicate the Recipient's height in either inches (in) or centimeters (cm) based upon an actual
                                measurement (if possible) or based on the Recipient's estimate.  
                                 
                                The measurement should be entered in inches (48 to 86) or centimeters (122 to 218). If you are
                                entering the patient's height in centimeters, enter 'C' after the number of centimeters.  
                                 
                                Your answer should be in one of the following two formats.  
                                 68    (representing inches) 
                                 173C  (representing centimeters) 
                                 
                                Enter NS for NO STUDY if the patient's height cannot be determined.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,5       RECIPIENT WEIGHT       0;5 FREE TEXT

              Recipient Weight   
              INPUT TRANSFORM:  S:X="NS"!(X="ns") X="NS" Q:X="NS"  K:X>700!(X<0) X D W^SROAMEAS
              OUTPUT TRANSFORM: S Y=$S(Y="NS":"NO STUDY",Y["K":+Y_" KG",+Y:Y_" LBS.",1:Y)
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter Recipient weight. 
              DESCRIPTION:      Indicate the Recipient's most recent weight before surgery in either pounds (lbs) or kilograms (kg)
                                based upon an actual measurement (if possible) or based on the Recipient's estimate.  
                                 
                                The weight should be entered in pounds (50 to 700) or kilograms (23 to 318). If you are entering
                                the patient's weight in kilograms, enter 'K' after the number of kilograms.  
                                 
                                Your answer should be in one of the following formats.  
                                 178     (weight in pounds) 
                                 80K     (weight in Kilograms) 
                                 
                                Enter NS for NO STUDY if the patient's weight cannot be determined.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,9       RECIPIENT IVIG         0;9 SET

              IVIG Recipient   
                                '1' FOR BEFORE TRANSPLANT; 
                                '2' FOR AFTER TRANSPLANT; 
                                '3' FOR BOTH; 
                                '4' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter status as IVIG Recipient. 
              DESCRIPTION:      Indicate if transplant recipient receives intravenous immunoglobulin (IVIG).  IVIG is used to treat
                                acute humoral rejection after organ transplantation.  IVIG is also used to reduce antibody titers 
                                prophylactically to permit ABO incompatible and cross match positive renal transplants. 


139.5,10      RECIPIENT ABO BLOOD TYPE 0;10 SET

              Recipient ABO Blood Type   
                                'A' FOR A; 
                                'B' FOR B; 
                                'AB' FOR AB; 
                                'O' FOR O; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the ABO blood type of the organ recipient. 
              DESCRIPTION:
                                This is the ABO blood type of the organ recipient.  


139.5,11      DATE PLACED ON WAITING LIST 0;11 DATE

              Date Placed on Waiting List   
              INPUT TRANSFORM:  S %DT="EXP" D ^%DT S X=Y K:X<1 X
              LAST EDITED:      JUL 16, 2008 
              HELP-PROMPT:      Enter the date that the patient was placed on the waiting list. 
              DESCRIPTION:
                                Indicate date entered on UNOS Waiting List for Transplant.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,12      RECIPIENT CMV          0;12 SET

              Recipient CMV   
                                '+' FOR POSITIVE; 
                                '-' FOR NEGATIVE; 
              LAST EDITED:      MAY 28, 2008 
              HELP-PROMPT:      Enter the CMV status of transplant recipient. 
              DESCRIPTION:      This is the Recipient CMV status field. The field will capture the cytomegalovirus (CMV) serologic
                                status of the transplant recipient.  


139.5,13      RECIPIENT HLA-A TYPING 0;13 FREE TEXT

              Recipient HLA-A Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-A typing of the organ recipient. 
              DESCRIPTION:      This is the HLA-A typing status of the organ recipient.  It is Human Leukocyte Antigen (HLA) typing
                                - described as A, B, C, BW, DQ, & DR locus.  Acceptable answers are numerical in the format of # to
                                #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,14      RECIPIENT HLA-B TYPING 0;14 FREE TEXT

              Recipient HLA-B Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-B typing of the organ recipient. 
              DESCRIPTION:      This is the HLA-B typing status of the organ recipient.  It is Human Leukocyte Antigen (HLA) typing
                                - described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format of # to
                                #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,15      RECIPIENT HLA-C TYPING 0;15 FREE TEXT

              Recipient HLA-C Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-C typing of the organ recipient. 
              DESCRIPTION:      This is the HLA-C typing status of the organ recipient.  It is Human Leukocyte Antigen (HLA) typing
                                - described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format of # to
                                #,#,#,#. The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,16      RECIPIENT HLA-BW TYPING 0;16 FREE TEXT

              Recipient HLA-BW Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-BW typing of the organ recipient. 
              DESCRIPTION:      This is the HLA-BW typing status of the organ recipient.  It is Human Leukocyte Antigen (HLA)
                                typing - described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format
                                of # to #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,17      RECIPIENT HLA-DR TYPING 0;17 FREE TEXT

              Recipient HLA-DR Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-DR typing of the organ recipient. 
              DESCRIPTION:      This is the HLA-DR typing status of the organ recipient.  It is Human Leukocyte Antigen (HLA)
                                typing - described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format
                                of # to #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,18      RECIPIENT HLA-DQ TYPING 0;18 FREE TEXT

              Recipient HLA-DQ Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-DQ typing of the organ recipient. 
              DESCRIPTION:      This is the HLA-DQ typing status of the organ recipient.  It is Human Leukocyte Antigen (HLA)
                                typing - described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format 
                                of # to #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments. 


139.5,19      TRANSPLANT COMMENTS    .02;1 FREE TEXT

              Transplant Comments   
              INPUT TRANSFORM:  K:$L(X)>130!($L(X)<1) X
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter additional comments as necessary for transplant assessments. 
              DESCRIPTION:      The Transplant comments include additional information not available elsewhere on this form. This
                                field has a limit of 130 characters.  


139.5,20      ACETAMINOPHEN TOXICITY .1;1 SET

              Acetaminophen Toxicity   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Acetaminophen Toxicity status of the organ recipient. 
              DESCRIPTION:      Acetaminophen Toxicity is a condition as defined by development of encephalopathy within 8 weeks of
                                onset of illness and an acetaminophen level exceeding 4000 units/liter or diagnosis as documented
                                by an attending physician.  


139.5,21      ACUTE LIVER FAILURE    .1;2 SET

              Acute Liver Failure   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Acute Liver Failure status of the organ recipient. 
              DESCRIPTION:      Acute Liver Failure is when a patient develops encephalopathy within 8 weeks of an onset of illness
                                or as documented by an attending physician.  


139.5,22      LUNG CANCER            .1;3 SET

              Lung Cancer   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the lung cancer status of the organ recipient. 
              DESCRIPTION:      Indicate presence or history of lung cancer with pathology report confirming diagnosis as
                                documented by attending physician.  


139.5,23      ALCOHOLIC CIRRHOSIS    .1;4 SET

              Alcoholic Cirrhosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter the Alcoholic Cirrhosis status of the organ recipient. 
              DESCRIPTION:      Continued alcohol abuse in many patients will result in the development of alcoholic cirrhosis
                                which causes permanent scarring of the liver. Answer "YES" if a diagnosis of Alcoholic cirrhosis is 
                                documented by a physician in medical record.  


139.5,24      ALPHA 1 ANTI-TRYPSIN DEF .1;5 SET

              Alpha 1 Anti-Trypsin Deficiency   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Alpha 1 Anti-Trypsin Deficiency status of the organ recipient. 
              DESCRIPTION:      Alpha 1 Anti-Trypsin Deficiency is the genetic predisposition to produce the protein
                                (alpha1-antitrypsin) that helps protect the lungs.  Indicate if patient has diagnosis of alpha-1
                                anti-trypsin deficiency documented by an attending physician.  


139.5,25      BRONCHIECTASIS         .1;6 SET

              Bronchiectasis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Bronchiectasis status of the organ recipient. 
              DESCRIPTION:      Bronchiectasis is an abnormal destruction and dilation of the large airways; or a diagnosis of
                                bronchiectasis documented by an attending physician.  


139.5,26      GLOMERULAR SCLEROSIS/NEPHRITIS .1;7 SET

              Glomerular Sclerosis/Nephritis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the Glomerular Sclerosis/Nephritis diagnosis status of the organ recipient. 
              DESCRIPTION:
                                Glomerular Sclerosis/Nephritis is kidney disease involving primarily the glomeruli.  


139.5,27      GRAFT FAILURE          .1;8 SET

              Graft Failure   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      MAY 28, 2008 
              HELP-PROMPT:      Enter Graft Failure status of the organ recipient. 
              DESCRIPTION:      For kidney transplants, Graft Failure is documented return to maintenance dialysis after a
                                successful kidney transplant.  
                                 
                                For liver transplants, graft failure is failure of transplanted liver caused by the etiologic
                                factor for which the original transplant was performed or the diagnosis of graft failure from
                                recurrent disease documented in the medical record.  


139.5,28      HBV CIRRHOSIS (HEPATITIS B) .1;9 SET

              HBV Cirrhosis (Hepatitis B)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the HBV Cirrhosis (hepatitis B) status of the organ recipient. 
              DESCRIPTION:      Cirrhosis characterized by hepatitis B surface antibody, hepatitis surface antigen, and hepatitis B
                                core antibody positive and pathology of cirrhosis on liver biopsy.  


139.5,29      HCC (HEPATOCELLULAR CA) .1;10 SET

              HCC (Hepatocellular CA)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the HCC (Hepatocellular CA) status of the organ recipient. 
              DESCRIPTION:      HCC (Hepatocellular carcinoma) is characterized by the presence of a lesion on two separate liver
                                imaging studies and at least one of the following: a vascular blush corresponding to the area of
                                suspicion seen on other imaging studies; an alpha-fetoprotein level of >200 ng/ml; an arteriogram
                                confirming a tumor; a biopsy confirming HCC; chemoembolization of lesion, radio frequency, cryo, or
                                chemical ablation of the lesion; or diagnosis of hepatocellular carcinoma documented in medical
                                record or explant pathology showing hepatocellular carcinoma.  


139.5,30      HCV CIRRHOSIS (HEPATITIS C) .1;11 SET

              HCV Cirrhosis (Hepatitis C)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the HCV Cirrohosis (hepatitis C) status of the organ recipient. 
              DESCRIPTION:      HCV Cirrohosis (Hepatitis C) is characterized by hepatitis C antibody positive and/or PCR positive
                                for HCV RNA and pathology of cirrhosis on liver biopsy.  


139.5,31      DONOR HEIGHT           1;2 FREE TEXT

              Donor Height   
              INPUT TRANSFORM:  S:X="NS"!(X="ns") X="NS" Q:X="NS"  K:+X>300!(+X<0) X D H^SROAMEAS
              OUTPUT TRANSFORM: S Y=$S(Y="NS":"NO STUDY",Y["C":+Y_" CM.",+Y:Y_" INCHES",1:Y)
              LAST EDITED:      JUL 17, 2008 
              HELP-PROMPT:      Enter donor height. 
              DESCRIPTION:      Indicate the Donor's height in either inches (in) or centimeters (cm) based upon an actual
                                measurement (if possible) or based on estimate.  
                                 
                                The measurement should be entered in inches (48 to 86) or centimeters (122 to 218). If you are
                                entering the donor's height in centimeters, enter 'C' after the number of centimeters.  
                                 
                                Your answer should be in one of the following two formats.  
                                 68    (representing inches) 
                                 173C  (representing centimeters) 
                                 
                                Enter NS for NO STUDY if the donor's height cannot be determined.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,32      INTERSTITIAL LUNG DISEASE .1;13 SET

              Interstitial Lung Disease   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Interstitial Lung Disease status of the organ recipient. 
              DESCRIPTION:      Interstitial Lung Disease (ILD) refers to a group of lung diseases which affect the alveolar
                                epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic
                                tissues; or a diagnosis of interstitial lung disease documented by an attending physician.  


139.5,33      MEMBRANOUS NEPHROPATHY .1;14 SET

              Membranous Nephropathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Membranous Nephropathy status of the organ recipient. 
              DESCRIPTION:      This is the Membranous Nephropathy status of the organ recipient.  Membranous Nephropathy is a
                                kidney disorder resulting in disruption of kidney function because of inflammation of the
                                glomerulus and changes in the glomerular basement membrane.  


139.5,34      METABOLIC              .1;15 SET

              Metabolic   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Metabolic status of the organ recipient. 
              DESCRIPTION:      Indicate yes if one of the following diagnoses is recorded in patient's medical record:
                                hemachromatosis, alpha1 antitrypsin deficiency, Wilson's, Banti's, lupoid.  


139.5,35      NASH                   .1;16 SET

              NASH    
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Non-alcoholic steatohepatitis status of the organ recipient. 
              DESCRIPTION:      Non-alcoholic steatohepatitis (or non-alcoholic fatty liver disease) - hepatitis or cirrhosis
                                diagnosed by liver biopsy pathology or a diagnosis of non-alcoholic steatohepatitis (or
                                non-alcoholic fatty liver disease) documented in the medical record.  


139.5,36      DONOR WEIGHT           1;3 FREE TEXT

              Donor Weight   
              INPUT TRANSFORM:  S:X="NS"!(X="ns") X="NS" Q:X="NS"  K:X>700!(X<0) X D W^SROAMEAS
              OUTPUT TRANSFORM: S Y=$S(Y="NS":"NO STUDY",Y["K":+Y_" KILOGRAMS",+Y:Y_" LBS.",1:Y)
              LAST EDITED:      JUL 17, 2008 
              HELP-PROMPT:      Enter donor weight. 
              DESCRIPTION:      Indicate the Donor's most recent weight before surgery in either pounds (lbs) or kilograms (kg)
                                based upon an actual measurement (if possible) or based on estimate.  
                                 
                                The weight should be entered in pounds (50 to 700) or kilograms (23 to 318). If you are entering
                                the donor's weight in kilograms, enter 'K' after the number of kilograms.  
                                 
                                Your answer should be in one of the following formats.  
                                 178     (weight in pounds) 
                                 80K     (weight in Kilograms) 
                                 
                                Enter NS for NO STUDY if the donor's weight cannot be determined.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,37      POLYCYSTIC DISEASE     .1;18 SET

              Polycystic Disease   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Polycystic Disease status of the organ recipient. 
              DESCRIPTION:      This is Polycystic Disease status of the organ recipient.  Polycystic Disease is a condition in
                                which multiple cysts on the kidneys cause the kidneys to fail.  


139.5,38      PRIMARY BILIARY CHOLANGITIS .1;19 SET

              Primary Biliary Cholangitis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Primary Biliary Cholangitis (PBC) status of the organ recipient. 
              DESCRIPTION:      Primary Biliary Cholangitis or Cirrhosis is an autoimmune liver disease where over time an antibody
                                created within the body attacks and destroys the bile ducts in the liver.  


139.5,39      PRIMARY SCLEROSING CHOLANGITIS .1;20 SET

              Primary Sclerosing Cholangitis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter the Primary Sclerosing Cholangitis status of the organ recipient. 
              DESCRIPTION:
                                Indicate whether a diagnosis of Primary Sclerosing Cholangitis is documented in the medical record.  


139.5,40      PULMONARY FIBROSIS     .1;21 SET

              Pulmonary Fibrosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Pulmonary Fibrosis status of the organ recipient. 
              DESCRIPTION:      Pulmonary Fibrosis involves scarring of the lung.  Gradually, the air sacs of the lungs become
                                replaced by fibrotic tissue.  When the scar forms, the tissue becomes thicker causing an
                                irreversible loss of the tissue's ability to transfer oxygen into the bloodstream. Indicate if 
                                patient has diagnosis of pulmonary fibrosis documented in the medical record.  


139.5,41      PULMONARY HYPERTENSION  .1;22 SET

              Pulmonary Hypertension   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the Pulmonary Hypertension status of the organ recipient. 
              DESCRIPTION:      Indicate if patient has diagnosis of pulmonary hypertension with Mean PA pressure > 35 mmHg
                                documented in medical record.  


139.5,42      RENAL CANCER           .1;23 SET

              Renal Cancer   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 21, 2008 
              HELP-PROMPT:      Enter the Renal Cancer status of the organ recipient. 
              DESCRIPTION:      This is the Renal Cancer status of the organ recipient.  Renal Cancer is malignant neoplasm of the
                                kidney.  


139.5,43      SARCOIDOSIS            .1;24 SET

              Sarcoidosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Sarcoidosis status of the organ recipient. 
              DESCRIPTION:      Indicate if the patient was diagnosed with clinical manifestations of cardiac sarcoidosis, which is
                                dependent upon the location and extent of granulomatous inflammation. Cardiac involvement may 
                                precede, follow, or occur concurrently with involvement of the lungs or other organs.  


139.5,44      DONOR RACE             44;0 SET Multiple #139.544 (Add New Entry without Asking)


139.544,.01     DONOR RACE             0;1 SET (Multiply asked)

                Donor Race   
                                  '3' FOR AMERICAN INDIAN OR ALASKA NATIVE; 
                                  'A' FOR NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER; 
                                  '9' FOR BLACK OR AFRICAN AMERICAN; 
                                  '8' FOR ASIAN; 
                                  'B' FOR WHITE; 
                                  'C' FOR DECLINED TO ANSWER/UNANSWERED; 
                                  'D' FOR UNKNOWN BY PATIENT; 
                LAST EDITED:      MAY 06, 2008 
                HELP-PROMPT:      Enter the Donor Race 
                DESCRIPTION:      Indicate the donor-reported race.  Select all appropriate responses: 
                                   
                                  American Indian or Alaskan Native - Patient indicates race as 
                                           American Indian or Alaskan Native Native Hawaiian or Pacific Islander - Patient
                                  indicates race as 
                                           Native Hawaiian or Pacific Islander Black or African American - Patient indicates race
                                  as Black or 
                                           African American Asian - Patient indicates race as Asian White - Patient indicates race
                                  as White Declined to Answer - Patient elects not to indicate race Unknown by Patient - Patient
                                  indicates race as unknown Unanswered - Race unanswered 

                CROSS-REFERENCE:  139.544^B 
                                  1)= S ^SRT(DA(1),44,"B",$E(X,1,30),DA)=""
                                  2)= K ^SRT(DA(1),44,"B",$E(X,1,30),DA)




139.5,45      DONOR GENDER           1;5 SET

              Donor Gender   
                                'M' FOR MALE; 
                                'F' FOR FEMALE; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the Donor Gender. 
              DESCRIPTION:
                                Indicate donor's gender as "M" if male, "F" if female.  


139.5,46      DONOR AGE              1;6 FREE TEXT

              Donor Age   
              INPUT TRANSFORM:  S:X="NS"!(X="ns") X="NS" Q:X="NS"  K:+X'=X!(X>135)!(X<0) X D Y^SRTPUTL
              OUTPUT TRANSFORM: S Y=$S(Y="NS":"NO STUDY",Y:+Y_" YEARS",1:Y)
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the age of the donor. 
              DESCRIPTION:      This is the age of the donor at the time of organ harvest. Field will be automatically calculated
                                and filled if DONOR DATE OF BIRTH entered. Enter NS for NO STUDY if the donor's age cannot be
                                determined.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,47      BILIARY STRICTURE      .1;26 SET

              Biliary Stricture   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Biliary Stricture status of the organ recipient. 
              DESCRIPTION:      Narrowing or occlusion of the bile ducts either extrahepatic  (for choledochocholedochostomy or
                                choledochojejunostomy) or intrahepatic, seen on MRCP, ERCP, or PTC or as documented in the medical
                                record.  


139.5,48      DONOR ABO BLOOD TYPE   1;8 SET

              Donor ABO Blood Type   
                                'A' FOR A; 
                                'B' FOR B; 
                                'AB' FOR AB; 
                                'O' FOR O; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the ABO blood type of the organ donor. 
              DESCRIPTION:
                                This is the ABO blood type of the organ donor.  


139.5,49      DONOR CMV              1;9 SET

              Donor CMV   
                                '+' FOR POSITIVE; 
                                '-' FOR NEGATIVE; 
              LAST EDITED:      MAY 06, 2008 
              HELP-PROMPT:      Enter the CMV status of transplant donor. 
              DESCRIPTION:
                                Indicate whether the donor tested positive or negative to Cytomegalovirus.  


139.5,50      LAS SCORE AT LISTING   0;19 NUMBER

              LAS Score at Listing   
              INPUT TRANSFORM:  K:+X'=X!(X>100)!(X<0)!(X?.E1"."1.N) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter the LAS Score at Listing. 
              DESCRIPTION:      Lung allocation score (LAS) is a calculated value which is used by the United Network for Organ
                                Sharing (UNOS) based upon a number of factors including age, geographic distance, lab test results,
                                and disease diagnosis for prospective lung transplants recipients. Indicate patient Lung Allocation
                                Score at Listing with UNOS. Enter a number between 0 and 100.  


139.5,51      LAS SCORE AT TRANSPLANT 0;20 NUMBER

              LAS Score at Transplant   
              INPUT TRANSFORM:  K:+X'=X!(X>100)!(X<0)!(X?.E1"."1.N) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter the LAS Score at Transplant. 
              DESCRIPTION:      Lung allocation score (LAS) is a calculated value which is used by the United Network for Organ
                                Sharing (UNOS) based upon a number of factors including age, geographic distance, lab test results,
                                and disease diagnosis for prospective lung transplants recipients. Indicate patient Lung Allocation
                                Score at Transplant with UNOS. Enter a number between 0 and 100.  


139.5,52      MELD SCORE AT LISTING  0;21 NUMBER

              MELD Score at Listing   
              INPUT TRANSFORM:  K:+X'=X!(X>40)!(X<6)!(X?.E1"."1.N) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter the MELD Score at Listing. 
              DESCRIPTION:      Biologic Model of End Stage Liver Disease score plus the extra points as defined by UNOS (for
                                example, for HCC or an appeal has been made for higher MELD score due to other clinical entities)
                                at time of listing and as documented in the UNOS data base. Enter a number between 6 and 40.  


139.5,53      BIOLOGIC MELD SCORE AT LISTING 0;22 NUMBER

              Biologic MELD score at listing   
              INPUT TRANSFORM:  K:+X'=X!(X>40)!(X<6)!(X?.E1"."1.N) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter the Biologic MELD Score at Listing. 
              DESCRIPTION:      Actual Model of End Stage Liver Disease score using the laboratory values of bilirubin, creatinine,
                                and INR at the time of listing and as documented in the UNOS data base. Enter a number between 6
                                and 40.  


139.5,54      MELD SCORE AT TRANSPLANT 0;23 NUMBER

              MELD score at transplant   
              INPUT TRANSFORM:  K:+X'=X!(X>40)!(X<6)!(X?.E1"."1.N) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter the MELD Score at Transplant. 
              DESCRIPTION:      Biologic Model of End Stage Liver Disease score plus the extra points as defined by UNOS (for
                                example, for HCC, or an appeal has been made for higher MELD score due to other clinical entities)
                                at time of transplant and as documented in the UNOS data base. Enter a number between 6 and 40.  


139.5,55      BIOLOGIC MELD SCORE AT TRANSP .01;10 NUMBER

              Biologic MELD score at transplant   
              INPUT TRANSFORM:  K:+X'=X!(X>40)!(X<6)!(X?.E1"."1N.N) X
              LAST EDITED:      MAY 14, 2008 
              HELP-PROMPT:      Enter the Biologic MELD Score at Transplant. 
              DESCRIPTION:      Actual Model of End Stage Liver Disease score using the laboratory values of bilirubin, creatinine,
                                and INR at the time of transplant and as documented in the UNOS data base. Enter a number between 6 
                                and 40.  


139.5,56      BILE LEAK              .11;20 SET

              Bile Leak   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Bile Leak status of the organ recipient. 
              DESCRIPTION:      Evidence of extravasation of bile from the biliary tree by a cholangiogram.  The contrast imaging
                                studies to obtain a cholangiogram include: ERCP, PTC, MRCP, or tube cholangiogram.  A HIDA scan can
                                also reveal a bile leak.  In addition, bile leak can be identified  as documented in the medical
                                record.  


139.5,57      UNOS STATUS AT TIME OF TRANSP .01;9 SET

              UNOS Status at time of Transplant   
                                'A' FOR 1A; 
                                'B' FOR 1B; 
                                '2' FOR 2; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the UNOS Status at the time of Transplant. 
              DESCRIPTION:      Indicate the UNOS (United Network for Organ Sharing database) status at the time the transplant
                                procedure was performed.  


139.5,58      UNOS STATUS AT TIME OF LISTING 0;8 SET

              UNOS Status at time of Listing   
                                'A' FOR 1A; 
                                'B' FOR 1B; 
                                '2' FOR 2; 
                                '7' FOR 7 - ON HOLD; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the UNOS Status at the time of listing. 
              DESCRIPTION:      Indicate the UNOS (United Network for Organ Sharing database) status at the time the heart
                                transplant procedure was listed.  


139.5,59      DIABETIC RETINOPATHY   .5;1 SET

              Diabetic Retinopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter YES if organ recipient is diagnosed with diabetic retinopathy. 
              DESCRIPTION:      Diabetic Retinopathy is damage to the blood vessels in the retina as a consequence of diabetes
                                mellitus. Enter YES if organ recipient is diagnosed with this condition. Otherwise, enter NO.  


139.5,60      DIABETIC NEUROPATHY    .5;2 SET

              Diabetic Neuropathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Diabetic Neuropathy status of the organ recipient. 
              DESCRIPTION:      Enter the Diabetic Neuropathy status of the organ recipient.  Diabetic Neuropathy is damage to the
                                nervous system as a consequence of diabetes mellitus which can include peripheral neuropathy
                                (sensory nervous system) or autonomic neuropathy (autonomic nervous system) or as defined by the
                                attending physician.  


139.5,61      CARDIAC DISEASE        .5;3 SET

              Cardiac Disease (CAD, AF, EF<50%)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the presence of Cardiac Disease (CAD, AF, EF<50%) in organ recipient. 
              DESCRIPTION:      Any documented cardiac abnormality (i.e. EKG abnormality, fixed or reversible defects, cardiac
                                disease on heart catheterization, hypertension, and hyperlipidemia).  


139.5,62      INOTROPE DEPENDENT PRE-TRANSP .5;4 SET

              Inotrope Dependent Pre-Transplant   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Indicate whether the patient required an inotropic agent. 
              DESCRIPTION:      Indicate if the patient required an inotropic agent (dobutamine, milrinone, levophed, etc.) to
                                maintain adequate cardiac output while awaiting a donor heart.  


139.5,63      DIVISION               8;1 POINTER TO INSTITUTION FILE (#4)

              Medical Center Division   
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the name of the division associated with this transplant. 
              DESCRIPTION:
                                This is the name of the institution credited for performing this transplant.  


139.5,64      DONOR HLA-A TYPING     1;10 FREE TEXT

              Donor HLA-A Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-A typing of the organ donor. 
              DESCRIPTION:      This is the HLA-A typing status of the organ Donor.  It is Human Leukocyte Antigen (HLA) typing -
                                described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format of # to
                                #,#,#,#. The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,65      DONOR HLA-B TYPING     1;11 FREE TEXT

              Donor HLA-B Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-B typing of the organ donor. 
              DESCRIPTION:      This is the HLA-B typing status of the organ Donor.  It is Human Leukocyte Antigen (HLA) typing -
                                described as A, B, C, BW, DQ, & DR locus.  Acceptable answers are numerical in the format of # to
                                #,#,#,#. The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,66      DONOR HLA-C TYPING     1;12 FREE TEXT

              Donor HLA-C Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-C typing of the organ donor. 
              DESCRIPTION:      This is the HLA-C typing status of the organ Donor.  It is Human Leukocyte Antigen (HLA) typing -
                                described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format of # to
                                #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,67      DONOR HLA-BW TYPING    1;13 FREE TEXT

              Donor HLA-BW Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-BW typing of the organ donor. 
              DESCRIPTION:      This is the HLA-BW typing status of the organ Donor.  It is Human Leukocyte Antigen (HLA) typing -
                                described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format of # to
                                #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,68      CROSSMATCH D/R         3;7 SET

              Crossmatch D/R   
                                '+' FOR POSITIVE; 
                                '-' FOR NEGATIVE; 
              LAST EDITED:      MAY 06, 2008 
              HELP-PROMPT:      Enter status of Crossmatch between donor and recipient. 
              DESCRIPTION:      Crossmatch is pretransfusion testing or compatibility testing. It is a series of procedures used to
                                give an indication of blood group compatibility between the donor and the recipient and to detect 
                                irregular antibodies in the recipient's serum.  


139.5,69      DECEASED DONOR         3;1 SET

              Deceased Donor   
                                '1' FOR DCD (Donor after Cardiac Death); 
                                '2' FOR ECD (Extended Criteria Donor); 
                                '3' FOR SCD (Standard Criteria Donor); 
                                '4' FOR ECD-DCD; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      SEP 11, 2008 
              HELP-PROMPT:      Enter the type of the deceased donor. 
              DESCRIPTION:      Transplanted organ was harvested from a deceased donor. Acceptable answers include DCD (Donor after
                                Cardiac Death), ECD (Extended Criteria Donor), SCD (Standard Criteria Donor), ECD-DCD, and No
                                Study.  


139.5,70      DONOR DATE OF BIRTH    1;1 DATE

              Donor Date of Birth   
              INPUT TRANSFORM:  S %DT="EP" D ^%DT S X=Y K:1701231>X!(DT
                                35 mmHg for right heart catheterization measurement.  


139.5,72      DONOR HLA-DQ TYPING    1;14 FREE TEXT

              Donor HLA-DQ Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-DQ typing of the organ donor. 
              DESCRIPTION:      This is the HLA-DQ typing status of the organ Donor.  It is Human Leukocyte Antigen (HLA) typing -
                                described as A, B, C, BW, DQ, & DR locus. Acceptable answers are numerical in the format of # to
                                #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,73      DONOR HLA-DR TYPING    1;15 FREE TEXT

              Donor HLA-DR Typing   
              INPUT TRANSFORM:  K:$L(X)>19!($L(X)<1) X I $D(X) D HLA^SRTPUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the HLA-DR typing of the organ donor. 
              DESCRIPTION:      This is the HLA-DR typing status of the organ Donor.  It is Human Leukocyte Antigen (HLA) typing -
                                described as A, B, C, BW, DQ, & DR locus.  Acceptable answers are numerical in the format of # to
                                #,#,#,#.  The numbers between commas can be from 0 to 9999.  
                                 
                                NS (No Study) is also an acceptable response for heart transplants assessments.  


139.5,74      PULMONARY HYPER/ELEVATED PAP .5;5 SET

              Pulmonary Hypertension / Elevated PAP Not Reversible   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the status of Pulmonary Hypertension / Elevated PAP not reversible. 
              DESCRIPTION:      Indicate if the patient has Pulmonary Hypertension or an Elevated PAP not reversible by sodium
                                nitroprusside (Nipride).  


139.5,75      LIVER DISEASE          .5;6 SET

              Liver Disease (Hep C+, Hep B+, cirrhosis)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the presence of Liver Disease (Hep C+, Hep B+, cirrhosis) in organ recipient. 
              DESCRIPTION:      Indicate the presence of liver disease such as positive HCV, Hep BsAg, or documented cirrhosis in
                                organ transplant recipient.  


139.5,76      COPD                   .5;7 SET

              COPD    
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter status of COPD. 
              DESCRIPTION:      Indicate if the patient has chronic obstructive pulmonary disease (COPD) resulting in functional
                                disability, and/or hospitalization, and/or requiring chronic bronchodilator therapy, and/or an FEV1
                                of less than 75% of predicted.  


139.5,77      DONOR SUBSTANCE ABUSE  1;4 SET

              Donor Substance Abuse   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      MAY 19, 2008 
              HELP-PROMPT:      Enter the Donor Substance Abuse status of the organ donor. 
              DESCRIPTION:      This is any documented history of illicit or recreational drug abuse of the donor.  The route may
                                be intravenous, subcutaneous, intranasal, oral, or inhaled.  The drugs may include opioids,
                                methamphetamines, cocaine, hallucinogens, marijuana, alcohol or other substances.  


139.5,78      PORTO PULMONARY HYPERTENSION .5;9 SET

              Porto Pulmonary Hypertension   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Porto Pulmonary Hypertension status of the organ recipient. 
              DESCRIPTION:      The pulmonary arterial vasculopathy associated with elevated pulmonary artery pressure (mean >
                                35mmHg) and as a consequence of severe hepatic dysfunction or as documented in the medical record.  


139.5,79      BLEEDING ESOPH/GASTRIC VARICES .5;10 SET

              History of Bleeding Esophageal and/or Gastric Varices   
                                'B' FOR BLEEDING; 
                                'NB' FOR NOT BLEEDING; 
                                'N' FOR NO; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the History of Bleeding Esophageal and/or Gastric Varices status of the organ recipient. 
              DESCRIPTION:      The presence of upper gastrointestinal bleeding from esophageal or gastric varices any time in the
                                patient's medical history.  


139.5,80      PRE-TRANSPLANT MALIGNANCY .5;11 SET

              Pre-Transplant Malignancy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Pre-transplant Malignancy status of the organ recipient. 
              DESCRIPTION:      This is Pre-transplant Malignancy status of the organ recipient.  Pre-transplant Malignancy is any
                                history of solid organ, blood cell, or lymph node malignancy prior to kidney transplantation.  


139.5,81      PRE-TRANSPLANT SKIN MALIGNANCY .5;12 SET

              History of Preop Transplant Skin Malignancy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter the status of the history of pre-transplant skin malignancy of the organ recipient. 
              DESCRIPTION:      Indicate if the patient has any neoplasm or tumor of the skin that is biopsy-proven to be malignant
                                prior to organ transplant.  


139.5,82      OTHER PRE-TRANS MALIGNANCY .5;13 SET

              History of Other Pre-Transplant Malignancy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the history of other pre-transplant malignancy status (other than skin) of the organ 
                                recipient. 
              DESCRIPTION:      Indicate if patient has history of solid organ, blood cell, or lymph node malignancy (other than
                                skin) prior to organ transplantation.  


139.5,83      RECIPIENT SUBSTANCE ABUSE .5;14 SET

              Recipient Substance Abuse   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      MAY 29, 2008 
              HELP-PROMPT:      Enter the Recipient Substance Abuse status of the organ recipient. 
              DESCRIPTION:      Indicate if there is any documented history of illicit or recreational drug abuse by the organ
                                recipient.  The route may be intravenous, subcutaneous, intranasal, oral, or inhaled.  The drugs 
                                may include opioids, methamphetamines, cocaine, hallucinogens, marijuana, alcohol or other
                                substances.  


139.5,84      ACTIVE INFECTION FOR PSC .5;15 SET

              Active Infection for PSC   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the status of active infection in liver. 
              DESCRIPTION:      The presence of infection related to the diseased biliary tract in the native liver at the time of
                                liver transplantation. The infection would be manifest as cholangitis, bacteremia, or biliary
                                sepsis.  


139.5,85      WARM ISCHEMIA TIME FOR ORGAN 3;4 NUMBER

              Warm Ischemia Time For Organ   
              INPUT TRANSFORM:  K:+X'=X!(X>3000)!(X<0)!(X?.E1"."1.N) X
              LAST EDITED:      AUG 27, 2008 
              HELP-PROMPT:      Enter the warm ischemia time for organ in minutes (0-3000). 
              DESCRIPTION:      Enter warm ischemia time for organ in minutes as written on transplant data sheet or operative
                                note. This is defined by the time that the donor organ is off ice until the time of reperfusion.  

              RECORD INDEXES:   AD (#547)

139.5,86      ACUTE/CHRONIC ENCEPHALOPATHY .5;17 SET

              Acute or Chronic Encephalopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Acute or Chronic Encephalopathy status of the organ recipient. 
              DESCRIPTION:      History of new onset of hepatic encephalopathy, recurrent hepatic encephalopathy, or a state of
                                ongoing, continued hepatic encephalopathy as documented in the medical record.  


139.5,87      COLD ISCHEMIA TIME FOR ORGAN 3;5 NUMBER

              Cold Ischemia Time for Organ   
              INPUT TRANSFORM:  K:+X'=X!(X>6000)!(X<0)!(X?.E1"."1.N) X
              LAST EDITED:      AUG 27, 2008 
              HELP-PROMPT:      Enter the cold ischemia time for organ in minutes (0-6000). 
              DESCRIPTION:      Enter cold ischemia time for organ in minutes as written on transplant data sheet or operative
                                note. This is defined by the time that the donor organ is cross-clamped to the time that the donor 
                                organ is removed from the ice.  

              RECORD INDEXES:   AD (#547)

139.5,88      HISTORY OF ASCITES     .5;19 SET

              History of Ascites   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter 'YES' if the organ recipient has a history of fluid accumulation in the peritoneal cavity. 
              DESCRIPTION:      The presence of ascites fluid (presence of fluid accumulation in the peritoneal cavity noted on
                                physical exam, abdominal ultrasound, or abdominal CT/MRI) at any time in the patient's medical
                                history.  


139.5,89      TOTAL ISCHEMIA TIME FOR ORGAN 3;6 NUMBER

              Total Ischemia Time for Organ   
              INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1.N) X
              LAST EDITED:      AUG 27, 2008 
              HELP-PROMPT:      Enter the total ischemia time for organ in minutes (0-9999). 
              DESCRIPTION:      Enter the total ischemia time for organ in minutes which is the sum of warm ischemia time and cold
                                ischemia time.  

              TECHNICAL DESCR:  If both the Warm and Cold Ischemia fields contain values, the "AD" cross reference populates this
                                field with the sum of their values.  


139.5,90      NON-COMPLIANCE (MED AND DIET) .5;21 SET

              Non-Compliance (Med and Diet)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Indicate if organ recipient is non-compliant regarding medication and/or diet. 
              DESCRIPTION:      Enter the non-compliance (medication and diet) status of the organ recipient.  This refers to
                                documented history of nonadherence/noncompliance to medical regimens such as diet, exercise,
                                monitoring blood sugars, attending scheduled appointments and laboratory draws when requested.  


139.5,91      ON METHADONE           .5;22 SET

              On Methadone   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Methadone status of the organ recipient. 
              DESCRIPTION:      Patient who has had previous substance abuse with opioids and is currently prescribed methadone by
                                a physician or methadone clinic. This patient would be yes for drug abuse variable as well.  


139.5,92      POST-TX PROPHYLAXIS - TB .5;23 SET

              Post Transplant Prophylaxis for TB/Antimycobacterial Treatment   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NA' FOR NOT APPLICABLE; 
              LAST EDITED:      DEC 06, 2010 
              HELP-PROMPT:      Enter the Post Transplant Prophylaxis for TB/Antimycobacterial Treatment status of the patient. 
              DESCRIPTION:      Definition Revised (2010):  Indicate whether patient is receiving post-transplant prophylaxis
                                Tuberculosis/Antimycobacterial drugs continuously post operatively for at least 30 days. Indicate
                                Yes if patient receiving therapy. Indicate No if patient is indicated to receive therapy but
                                doesn't. Indicate Not Applicable if patient is not indicated to receive therapy.  


139.5,94      REJECTION              .11;19 SET

              Rejection   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter status of organ rejection in patient. 
              DESCRIPTION:      A diagnosis of acute rejection as made by pathologic evaluation of allograft biopsy or a diagnosis
                                of acute rejection as documented in the medical record.  


139.5,95      IGA NEPHROPATHY        .1;17 SET

              IgA Nephropathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the IgA Nephropathy status of organ recipient. 
              DESCRIPTION:      IgA Nephropathy is a kidney disorder caused by deposits of the protein immunoglobulin A (IgA)
                                inside the glomeruli within the kidney. The chronic kidney disease may progress over a period of 10
                                to 20 years. If this disorder leads to end-stage renal disease, the patient must go on dialysis or
                                receive a kidney transplant.  


139.5,96      CALCINEURIN INHIBITOR TOXICITY .11;4 SET

              Calcineurin Inhibitor Toxicity   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the Calcineurin Inhibitor Toxicity status of transplant recipient 
              DESCRIPTION:      Cyclosporin and tacrolimus are calcineurin inhibitors and are widely used as immunosuppressive
                                therapy.   Among the toxicities of the calcineurin inhibitor class are nephrotoxicity manifest as
                                acute renal failure, hyperkalemia with or without acidosis and progressive chronic renal failure
                                and neurotoxicity manifest primarily as tremors and headache.  


139.5,97      LITHIUM TOXICITY       .11;9 SET

              Lithium Toxicity   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the status of Lithium Toxicity for organ recipient. 
              DESCRIPTION:      Mild to moderate acute toxic reactions may occur at lithium drug concentrations from 1.5 - 2
                                mmol/L, and moderate to severe reactions at concentrations above 2 mmol/L. In patients with normal
                                renal clearance the acute toxic manifestations appear to occur in a fairly predictable sequence
                                related to lithium concentrations. Thirst and polyuria may be followed by increased drowsiness,
                                ataxia, tinnitus and blurred vision, indicating early intoxication. As intoxication progresses the
                                following manifestations may be encountered: confusion, increasing disorientation, muscle
                                twitchings, hyperreflexia, nystagmus, seizures, diarrhea, vomiting, and eventually coma and death. 
                                Long term lithium use can also cause nephrogenic diabetes insipidus and a chronic tubulointersitial
                                nephritis with progressive chronic kidney disease leading to ESRD.  


139.5,98      OBSTRUCTIVE UROPATHY FROM BPH .11;10 SET

              Obstructive Uropathy from BPH   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter status of Obstructive Uropathy from BPH. 
              DESCRIPTION:      Obstructive uropathy from BPH is a non-cancerous enlargement of the prostate gland causing
                                obstruction to the free flow of urine due to narrowing of the urethra. As obstruction progresses,
                                the bladder decompensates, increasingly larger amounts of residual urine are left behind. Infection
                                is frequently associated with the residual urine. This can be transmitted to the upper urinary
                                tracts, with ensuing hydroureter, hydronephrosis and progressive renal damage and if untreated to
                                ESRD.  


139.5,99      AUTOIMMUNE HEPATITIS   .11;11 SET

              Autoimmune Hepatitis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUN 04, 2008 
              HELP-PROMPT:      Enter the Autoimmune Hepatitis status of the organ recipient. 
              DESCRIPTION:      Hepatitis or cirrhosis due to immune cell attack of the liver causing inflammation and or cell
                                death; or diagnosis of autoimmune  hepatitis documented in medical record.  


139.5,100     CRYPTOGENIC CIRRHOSIS  .11;12 SET

              Cryptogenic Cirrhosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Cryptogenic Cirrhosis status of the organ recipient. 
              DESCRIPTION:      Cryptogenic Cirrhosis is cirrhosis of the liver by biopsy with no specific etiology for the
                                cirrhosis.  


139.5,101     CHRONIC REJECTION      .11;13 SET

              Chronic Rejection   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Chronic Rejection status of the organ recipient. 
              DESCRIPTION:      The diagnosis of chronic rejection as made by pathologic evaluation or a diagnosis of chronic
                                rejection documented in the medical record.  


139.5,102     HEPATIC ARTERY THROMBOSIS .11;14 SET

              Hepatic Artery Thrombosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Hepatic Artery Thrombosis status of the organ recipient. 
              DESCRIPTION:      Thrombosis of the liver allograft hepatic artery documented by ultrasound duplex, angiogram, or
                                another vascular imaging study; or a diagnosis of hepatic artery thrombosis documented in the 
                                medical record.  


139.5,103     LIVING DONOR           3;2 SET

              Living Donor   
                                'R' FOR RELATED; 
                                'U' FOR UNRELATED; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      MAY 15, 2008 
              HELP-PROMPT:      Enter the type of the living donor. 
              DESCRIPTION:
                                Transplanted organ was harvested from a living donor. 


139.5,104     DONOR WITH MALIGNANCY  3;3 SET

              Donor with Malignancy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      MAY 19, 2008 
              HELP-PROMPT:      Enter the status of the Donor with Malignancy. 
              DESCRIPTION:      Indicate if the donor has or has a history of a cancer, neoplasm, or tumor that grows in an
                                uncontrolled manner, invading nearby tissue and metastasizing (spreading) to other sites through
                                the bloodstream.  Entering 'NS' for 'No Study/Unknown' is also allowed.  


139.5,105     PRIMARY NON-FUNCTION   .11;16 SET

              Primary Non-Function   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter the Primary Non-Function of Liver status for the organ recipient. 
              DESCRIPTION:      Primary Non-Function is defined as failure in the function of the liver allograft within 7 days of
                                liver transplantation as defined by 1) or 2): 
                                 
                                1) AST > 4999 and one or both of the following: an INR >2.4, acidosis, 
                                   defined as having an arterial pH < 7.31 or venous pH of 7.25 and/or 
                                   lactate  > 3.9 mMol/L; 
                                 
                                2) anhepatic candidate; or diagnosis of primary non-function 
                                   documented in the medical record.  


139.5,106     SECOND SCLEROSING CHOLANGITIS .11;17 SET

              Secondary Sclerosing Cholangitis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Secondary Sclerosing Cholangitis (SSC) status of the organ recipient. 
              DESCRIPTION:
                                A diagnosis of secondary sclerosing cholangitis in medical record.  


139.5,107     TOXIC EXPOSURE         .11;18 SET

              Toxic Exposure   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Toxic Exposure status of the organ recipient. 
              DESCRIPTION:      Hepatitis and or necrosis of the liver due to a known hepatotoxic agent or diagnosis of toxic
                                exposure causing liver failure as documented in medical record.  


139.5,108     HIV POSITIVE           .5;8 SET

              HIV + (positive)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter YES if organ recipient is HIV positive. 
              DESCRIPTION:      Enter YES if organ recipient is HIV positive on laboratory test or HIV positive as documented in
                                the medical record. Otherwise, enter NO.  


139.5,109     POST-TX PROPHYLAXIS - CMV .5;20 SET

              Post Transplant Prophylaxis for CMV/Antiviral Treatment   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Post Transplant Prophylaxis for CMV/Antiviral Treatment status of the patient. 
              DESCRIPTION:      This is the Post Transplant Prophylaxis for CMV/Antiviral Treatment status of a patient who is
                                receiving ganciclovir, valganciclovir, or acyclovir continuously post operatively for at least 30
                                days.  


139.5,110     POST-TX PROPHYLAXIS - PCP .55;1 SET

              Post Transplant Prophylaxis for PCP/Antibacterial Treatment   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Post Transplant Prophylaxis for PCP/Antibacterial Treatment status of the patient. 
              DESCRIPTION:      This is the Post Transplant Prophylaxis for PCP/Antibacterial Treatment status of a patient
                                receiving septra/bactrim, pentamidine, or dapsone continuously post operatively for at least 30
                                days.  


139.5,111     PORTAL VEIN THROMBOSIS .11;21 SET

              Portal Vein Thrombosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Portal Vein Thrombosis status of the organ recipient. 
              DESCRIPTION:      Thrombosis of the liver allograft portal vein documented by ultrasound duplex, angiogram, or CT
                                angiogram or MRI; or a diagnosis of portal vein thrombosis as documented in the medical record.  


139.5,112     OTHER CARDIOMYOPATHY   .11;15 FREE TEXT

              Other Cardiomyopathy   
              INPUT TRANSFORM:  K:$L(X)>60!($L(X)<1) X
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter description of other cardiomyopathy. Your answer must be 1-60 characters. 
              DESCRIPTION:      If the patient was diagnosed with any other form of cardiomyopathy that is not listed elsewhere on
                                this form, specify details into the comment field.  


139.5,113     LUNG DISEASE           .55;3 SET

              Lung Disease   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUN 04, 2008 
              HELP-PROMPT:      Record the presence or absence of lung disease (COPD, Pulmonary HTN, Interstitial Disease) in organ 
                                recipient. 
              DESCRIPTION:      Indicate the presence of lung disease such as documented COPD, pulmonary hypertension, or
                                interstitial disease in organ transplant recipient.  


139.5,114     RENAL IMPAIRMENT       .55;4 SET

              Renal Impairment (Serum Creatinine >1.5)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Renal Impairment (Serum Creatinine >1.5) status. 
              DESCRIPTION:
                                Renal dysfunction is evidenced by a serum creatinine results over 1.5 mg/dl.  


139.5,115     INFECTION REQ ANTIBIOTICS .5;16 SET

              Active Infection Requiring Antibiotics   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the pre-transplant status of infection requiring antibiotics of the organ recipient. 
              DESCRIPTION:      Indicate the presence of infection in recipient of the target organ or system requiring antibiotic
                                treatment.  


139.5,116     BLEEDING/TRANSFUSIONS  10;1 SET

              Bleeding/Transfusions   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter status of Bleeding/Transfusions for organ recipient. 
              DESCRIPTION:      Any transfusion (including autologous) of packed red blood cells or  whole blood given from the
                                time the patient leaves the operating room up to and including 72 hours postoperatively. Report as
                                an occurrence for five or more units of packed red blood cell in the postoperative period including
                                hanging blood from the OR that is finished outside of the OR. If the patient receives shed blood, 
                                autologous blood, cell saver blood or pleurovac postoperatively, this is counted if greater than
                                four units. The blood may be given for any reason.  


139.5,117     PNEUMONIA              10;2 SET

              Pneumonia   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter status of Pneumonia for organ recipient. 
              DESCRIPTION:      Report patients with evidence of pneumonia at the time the patient is brought to the OR. Patients
                                with pneumonia must meet ONE of the following two criteria: 
                                     
                                Criterion 1.  Rales or dullness to percussion on physical examination of chest AND any of the
                                following: a. New onset of purulent sputum or change in character of sputum b. Organism isolate
                                from blood culture c. Isolation of pathogen from specimen obtained by transtracheal aspirate,
                                bronchial brushing, or biopsy 
                                 
                                OR 
                                 
                                Criterion 2.  Chest radiographic examination shows new or progressive infiltrate, consolidation,
                                cavitation, or pleural effusion AND any of the following: 
                                 
                                a. New onset of purulent sputum or change in character of sputum b. Organism isolated from blood
                                culture c. Isolation of pathogen from specimen obtained by transtracheal 
                                   aspirate, bronchial brushing, or biopsy d. Isolation of virus or detection of viral antigen in
                                respiratory 
                                   secretions e. Diagnostic single antibody titer (IgM) or fourfold increase in 
                                   paired serum samples (IgG) for pathogen f. Histopathologic evidence of pneumonia 


139.5,118     ON VENTILATOR >48 HOURS 10;3 SET

              On Ventilator > 48 Hours   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JAN 19, 2011 
              HELP-PROMPT:      Enter if patient remained on ventilator greater than 48 hours after transplant. 
              DESCRIPTION:      Definition Revised (2011): Total duration of ventilator-assisted respirations during postoperative
                                hospitalization was >48 hours. This can occur at any time during the 30-day period postoperatively.  
                                This time assessment is CUMULATIVE, not necessarily consecutive.  Ventilator-assisted respirations
                                can be via endotracheal tube, nasotracheal tube, or tracheostomy tube.  


139.5,119     CARDIAC ARREST REQ CPR 10;4 SET

              Cardiac Arrest Requiring CPR   
                                'N' FOR NO; 
                                'I' FOR INTRAOPERATIVELY; 
                                'P' FOR POSTOPERATIVELY; 
              LAST EDITED:      APR 19, 2011 
              HELP-PROMPT:      Enter if patient suffered Cardiac Arrest Requiring CPR. 
              DESCRIPTION:      Definition Revised (2011): Indicate if there was any cardiac arrest requiring external or open
                                cardiopulmonary resuscitation (CPR) occurring in the operating room, ICU, ward, or out-of-hospital
                                after the chest had been completely closed and within 30 days of surgery.  Patients with AICDs that
                                fire but the patient does not lose consciousness should be excluded.  
                                 
                                If patient had cardiac arrest requiring CPR, indicate whether the arrest occurred intraoperatively
                                or postoperatively. Indicate the one appropriate response: - intraoperatively: occurring while
                                patient was in the operating room - postoperatively:  occurring after patient left the operating
                                room.  


139.5,120     PSYCHOSIS              .11;22 SET

              Psychosis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Psychosis status of the organ recipient. 
              DESCRIPTION:      Documentation in the medical record of a mental state involving a loss of contact with reality that
                                may include hallucinations, delusional beliefs, or personality changes or the diagnosis of 
                                psychosis in the medical record.  


139.5,121     STROKE/CVA             10;6 SET

              Stroke/CVA   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                '1' FOR NO SYMPTOMS; 
                                '2' FOR <24 HOURS; 
                                '3' FOR 24-72 HOURS; 
                                '4' FOR >72 HOURS; 
              LAST EDITED:      JUL 11, 2011 
              HELP-PROMPT:      Enter status of Stroke/CVA. 
              DESCRIPTION:      VASQIP Definitions (2011): Indicate if the patient developed a new neurologic deficit with onset 
                                immediately post-operatively or occurring within the 30 days after surgery.  Neurologic deficits
                                are defined as an embolic, thrombotic, or hemorrhagic vascular accident or stroke with motor,
                                sensory, or cognitive dysfunction (e.g., hemiplegia,hemiparesis, aphasia, sensory deficit, impaired
                                memory).  Indicate the duration as follows: 
                                 1) no symptoms 
                                 2) symptomatic duration less than 24 hours 
                                 3) symptomatic duration of 24-72 hours 
                                 4) symptomatic duration >72 hours 

              SCREEN:           S DIC("S")="I ""YN""'[Y"
              EXPLANATION:      Screen prevents selection of YES and NO.

139.5,122     COMA > 24 HOURS POSTOP 10;7 SET

              Coma Greater than 24 Hours Postop (Y/N)   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 19, 2011 
              HELP-PROMPT:      Enter YES if the patient has significantly impaired level of consciousness > or = 24 hours 
                                postoperatively. 
              DESCRIPTION:      Definition Revised (2011): Indicate if either postoperatively or within 30 days of surgery there
                                was a significantly decreased level of consciousness (exclude transient disorientation or
                                psychosis) for greater than or equal to 24 hours as evidenced by lack of response to deep, painful
                                stimuli. Do not include drug-induced coma (e.g. Propofol drips, etc.) 


139.5,123     SUPERFICIAL INCISIONAL SSI 10;8 SET

              Superficial Incisional SSI   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Indicate if the patient has been diagnosed with a Superficial Incisional Surgical Site Infection 
                                (SSI). 
              DESCRIPTION:      Definition Revised (2004): Superficial incisional SSI is an infection that occurs within 30 days 
                                after the operation and infection involves only skin or subcutaneous tissue of the incision and at
                                least one of the following: 
                                 
                                 - Purulent drainage, with or without laboratory confirmation, from the 
                                   superficial incision.  
                                 - Organisms isolated from an aseptically obtained culture of fluid or 
                                   tissue from the superficial incision.  
                                 - At least one of the following signs or symptoms of infection:  pain 
                                   or tenderness, localized swelling, redness, or heat and superficial 
                                   incision is deliberately opened by the surgeon, unless incision is 
                                   culture-negative.  
                                 - Diagnosis of superficial incisional SSI by the surgeon or attending 
                                   physician.  
                                 
                                Do not report the following conditions as SSI: 
                                 - Stitch abscess (minimal inflammation and discharge confined to the 
                                   points of suture penetration).  
                                 - Infected burn wound.  
                                 - Incisional SSI that extends into the fascial and muscle layers (see 
                                   deep incisional SSI).  


139.5,124     DEEP INCISIONAL SSI    10;9 SET

              Deep Incisional SSI   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Indicate if the patient has been diagnosed with a Deep Incisional Surgical Site Infection (SSI) 
              DESCRIPTION:      Definition Revised (2004): Deep Incision SSI is an infection that occurs within 30 days after the 
                                operation and the infection appears to be related to the operation and infection involved deep soft
                                tissues (e.g., fascial and muscle layers) of the incision and at least one of the following: 
                                 
                                 - Purulent drainage from the deep incision but not from the 
                                   organ/space component of the surgical site.  
                                 - A deep incision spontaneously dehisces or is deliberately opened by 
                                   a surgeon when the patient has at least one of the following signs 
                                   or symptoms: fever (>38 C), localized pain, or tenderness, unless 
                                   site is culture-negative.  
                                 - An abscess or other evidence of infection involving the deep 
                                   incision is found on direct examination, during reoperation, or by 
                                   histopathologic or radiologic examination.  
                                 - Diagnosis of a deep incision SSI by a surgeon or attending 
                                   physician.  
                                 
                                Note: 
                                 - Report infection that involves both superficial and deep incision 
                                   sites as deep incisional SSI.  
                                 - Report an organ/space SSI that drains through the incision as a deep 
                                   incisional SSI.  


139.5,125     SYSTEMIC SEPSIS        10;10 SET

              Systemic Sepsis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Indicate if the patient has been diagnosed with a systemic sepsis. 
              DESCRIPTION:      Definition Revised (2007): Sepsis is a vast clinical entity that takes a variety of forms. The 
                                spectrum of disorders spans from relatively mild physiologic abnormalities to septic shock. Please
                                report the most significant level using the criteria below: 
                                 
                                1. Sepsis: Sepsis is the systemic response to infection. Report this variable if the patient has
                                clinical signs and symptoms of SIRS. SIRS is a widespread inflammatory response to a variety of
                                severe clinical insults. This syndrome is clinically recognized by the presence of two or more of
                                the following: 
                                   - Temp >38 degrees C or <36 degrees C 
                                   - HR >90 bpm 
                                   - RR >20 breaths/min or PaCO2 <32 mmHg(<4.3 kPa) 
                                   - WBC >12,000 cell/mm3, <4000 cells/mm3, or >10% immature (band) 
                                     forms 
                                   - Anion gap acidosis: this is defined by either: 
                                      [Na + K] - [Cl + HCO3 (or serum CO2)]. If this number is 
                                      greater than 16, then an anion gap acidosis is present.  
                                     or 
                                      Na - [Cl + HCO3 (or serum CO2)]. If this number is greater 
                                      than 12, then an anion gap acidosis is present.  
                                 
                                 and one of the following: 
                                   - positive blood culture 
                                   - clinical documentation of purulence or positive culture from any 
                                     site thought to be causative 
                                 
                                2. Severe Sepsis/Septic Shock: Sepsis is considered severe when it is associated with organ and/or
                                circulatory dysfunction. Report this variable if the patient has the clinical signs and symptoms of
                                SIRS or sepsis AND documented organ and/or circulatory dysfunction. Examples of organ dysfunction
                                include: oliguria, acute alteration in mental status, acute respiratory distress. Examples of
                                circulatory dysfunction include: hypotension, requirement of inotropic or vasopressor agents.  
                                 
                                * For the patient that had sepsis preoperatively, worsening of any of the above signs
                                postoperatively would be reported as a postoperative Examples: 
                                 
                                A patient comes into the emergency room with signs of sepsis - WBC 31, Temperature 104. CT shows an
                                abdominal abscess. He is given antibiotics and is then taken emergently to the OR to drain the
                                abscess. He receives antibiotics intraoperatively. Postoperatively his WBC and Temperature are
                                trending down.  
                                  POD#1 WBC 24, Temp 102 
                                  POD#2 WBC 14, Temp 100 
                                  POD#3 WBC 10, Temp 99 This patient does not have postoperative sepsis as his WBC and Temperature
                                are improving each postoperative day.  
                                 
                                Patient comes into the ER with s/s of sepsis - WBC 31, Temp 104. CT shows an abdominal abscess. He
                                is given antibiotics and is taken emergently to the OR to drain the abscess. He receives
                                antibiotics intraoperatively. Postoperatively his WBC and Temp are as follows: 
                                  POD#1 WBC 28, Temp 103 
                                  POD#2 WBC 24, Temp 102.6 
                                  POD#3 WBC 22, Temp 102 
                                  POD#4 WBC 21, Temp 101.6 
                                  POD#5 WBC 30, Temp 104 This patient does have postoperative sepsis because on postoperative day
                                #5, his WBC and Temperature increase. The patient is having worsening of the defined signs of
                                sepsis.  


139.5,126     RETURN TO SURGERY W/I 30 DAYS 10;11 SET

              Return to Surgery within 30 days   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter YES/NO whether Returned to Surgery within 30 Days. 
              DESCRIPTION:      This field documents returns to the operating room including all surgical procedures that required
                                the patient to be taken to the surgical operating room for intervention of any kind.  


139.5,127     SEIZURES               .11;23 SET

              Seizures   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Seizures status of the organ recipient. 
              DESCRIPTION:      Documentation of a sudden change in behavior due to an excessive electrical activity in the brain
                                or the diagnosis of seizure in the medical record.  


139.5,128     EMPHYSEMA              .1;12 SET

              Emphysema   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter status of emphysema in organ recipient. 
              DESCRIPTION:      Emphysema is a chronic obstructive pulmonary disease that is caused by loss of elasticity of the
                                lung tissue from destruction of structures supporting the alveoli and/or destruction of capillaries 
                                feeding the alveoli which often results in shortness of breath. Indicate if the patient has a
                                diagnosis of emphysema documented by an attending physician.  


139.5,129     OTHER DIAGNOSIS        .1;25 FREE TEXT

              Other Diagnosis   
              INPUT TRANSFORM:  K:$L(X)>50!($L(X)<1) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter description of other Diagnosis. 
              DESCRIPTION:      If the patient was diagnosed with any other condition that is not listed elsewhere on this form,
                                specify details into the comment field. Free text field will have a limit of 50 characters.  


139.5,130     NEW MECHANICAL CIRCULATORY 10;5 SET

              New Mechanical Circulatory Support   
                                'N' FOR NO; 
                                'I' FOR INTRAOPERATIVELY; 
                                'P' FOR POSTOPERATIVELY; 
              LAST EDITED:      MAR 24, 2011 
              HELP-PROMPT:      Indicate if patient required New Mechanical Circulatory Support after transplant. 
              DESCRIPTION:      Definition Revised (2004): Indicate if the patient left the operating room suite with or required
                                post-op placement of a new IABP, ECMO, or VAD for circulatory support within 30 days
                                perioperatively. A "yes" response is appropriate even if the pump is only used for a short time
                                perioperatively. A "yes" response, however, is only correct if the patient did not enter the
                                operating room with this same mechanical circulatory support, and the device insertion occurred 
                                AFTER the induction of  anesthesia.  
                                 
                                If patient had/required new mechanical circulatory support, indicate whether the placement occurred
                                intraoperatively or postoperatively.  Indicate the one appropriate response: 
                                 
                                - intraoperatively: occurring while patient was in the operating 
                                  room.  - postoperatively:  occurring after patient left the operating room.  
                                 
                                A "no" response is appropriate if the circulatory support device was placed as a prophylaxis before
                                the induction of anesthesia; however, if it was placed for any reason after the induction of
                                anesthesia, then a "yes" response is appropriate. A "no" response is also appropriate if the
                                primary operation is to insert a ventricular assist device.  


139.5,131     PREOP FUNCTIONAL HEALTH STATUS .5;18 SET

              Preop Functional Health Status   
                                'I' FOR INDEPENDENT; 
                                'P' FOR PARTIALLY DEPENDENT; 
                                'T' FOR TOTALLY DEPENDENT; 
                                'U' FOR UNKNOWN; 
              LAST EDITED:      JUL 17, 2008 
              HELP-PROMPT:      Enter the level of self care that summarizes the patient's status prior to surgery. 
              DESCRIPTION:      Definition Revised (2008): This is a question that focuses on the patient's abilities to perform 
                                activities of daily living (ADLs) in the 30 days prior to surgery.  Activities of daily living are
                                defined as 'the activities usually performed in the course of a normal day in a person's life'.
                                ADLs include: bathing, feeding, dressing, toileting, and mobility. Report the corresponding level
                                of self-care for activities of daily living demonstrated by this patient at the time the patient is
                                being considered as a candidate for surgery (which should be no longer than 30 days prior to
                                surgery). If the patient's status changes prior to surgery, that change should be reflected in your
                                assessment. For this time point, report the level of functional health status as defined by the
                                following criteria.  
                                 
                                 (1) Independent: The patient does not require assistance from another 
                                     person for any activities of daily living. This includes a person 
                                     who is able to function independently with prosthetics, equipment, 
                                     or devices.  
                                 
                                 (2) Partially dependent: The patient requires some assistance from 
                                     another person for activities of daily living. This includes a 
                                     person who utilizes prosthetics, equipment, or devices but still 
                                     requires some assistance from another person for ADLs.  
                                 
                                 (3) Totally dependent: The patient requires total assistance for all 
                                     activities of daily living.  
                                 
                                 (4) Unknown: If unable to ascertain the functional status for the time 
                                     point of 'prior to the current illness' only, report as unknown.  
                                 
                                All patients with psychiatric illnesses should be evaluated for their ability to function with or
                                without assistance with ADLs just as the non-psychiatric patient. For instance, if a patient with
                                schizophrenia is able to care for him/herself without the assistance of nursing care, he/she is
                                considered independent.  


139.5,132     PERIPHERAL VASCULAR DISEASE .5;25 SET

              Peripheral Vascular Disease   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter status of Peripheral Vascular Disease. 
              DESCRIPTION:      Indicate if the patient has peripheral vascular disease, defined as disease of the arteries to legs
                                below bifurcation of aorta manifested by exertional claudication, and/or ischemic rest pain, and/or
                                prior revascularization procedure(s) on vessels to legs, and/or absent or diminished pulses in
                                legs, and/or angiographic evidence of noniatrogenic peripheral arterial obstruction greater than or
                                equal to 50% of luminal diameter.  


139.5,133     GRAFT FAILURE DATE     10;13 FREE TEXT

              Graft Failure Date   
              INPUT TRANSFORM:  N SRX S SRX=X,%DT="EXP" D ^%DT S X=Y K:Y<1 X S:SRX="NS"!(SRX="ns") X="NS"
              OUTPUT TRANSFORM: S Y(0)=Y D DATE^SROAUTL
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter the date of Graft Failure. 
              DESCRIPTION:      This is the date of Graft Failure and return to maintenance dialysis after successful kidney
                                transplant. System will also accept an entry for NS (No Study) 

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,134     PANCREAS               11;1 SET

              Pancreas   
                                'S' FOR SPK; 
                                'P' FOR PAK; 
                                'N' FOR NO STUDY; 
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter type of pancreas transplant. 
              DESCRIPTION:      Occasionally, the kidney is transplanted together with the pancreas. SPK is a simultaneous pancreas
                                transplant and kidney transplant.  Both organs would be from the same donor. PAK is a pancreas 
                                transplant after a kidney transplant.  


139.5,135     GLUCOSE AT TIME OF LISTING 11;2 FREE TEXT

              Glucose at Time of Listing   
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>999)!(X<1)!(X?.E1"."1.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter value of Glucose at Time of Listing. 
              DESCRIPTION:      Glucose is blood sugar. Blood glucose helps measure pancreas function. This is the blood glucose
                                level of organ recipient at the time of listing as a transplant candidate. Enter NS to represent
                                "No Study" if this information is not available.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,136     C-PEPTIDE AT TIME OF LISTING 11;3 FREE TEXT

              C-peptide at Time of Listing   
              INPUT TRANSFORM:  N SRX S SRX=X K:X'?.N.1".".2N!(X>9)!(X<0)!(X?.E1"."2.N) X S:"nsNS"[SRX X="NS" I $D(X) S:X?1".".N X=
                                "0"_X
              LAST EDITED:      MAY 24, 2011 
              HELP-PROMPT:      Enter value of C-peptide at Time of Listing. (#.#) 
              DESCRIPTION:      Definition Revised (2010):  C-peptide is a peptide which is made when proinsulin is split into
                                insulin and c-peptide. Proinsulin is released from the pancreas into the blood in response to a
                                rise in serum glucose. Acceptable answers are numerical in the format of #.#.  Enter NS to
                                represent "No Study" if this information is not available.  


139.5,137     PANCREATIC DUCT ANASTOMOSIS 11;4 SET

              Pancreatic Duct Anastomosis   
                                'B' FOR BLADDER; 
                                'E' FOR ENTERIC; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      JUN 04, 2008 
              HELP-PROMPT:      Enter type of Pancreatic Duct Anastomosis.  
              DESCRIPTION:      The pancreatic duct anastomosis refers to the anastomosis of the duodenal pouch, which is connected
                                to the pancreas, for drainage of the digestive enzymes.  The anastomosis will be to the bladder, or 
                                to the intestine (enteric).  


139.5,138     GLUCOSE POST TRANSPLANT 11;5 FREE TEXT

              Glucose Post Transplant   
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>999)!(X<1)!(X?.E1"."1.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter value of Glucose Post Transplant. 
              DESCRIPTION:      Glucose is blood sugar. Blood glucose helps measure pancreas function. Enter the blood glucose
                                level of the organ recipient after transplant.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,139     AMYLASE POST TRANSPLANT 11;6 FREE TEXT

              Amylase Post Transplant   
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>999)!(X<1)!(X?.E1"."1.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter value of Amylase Post Transplant. 
              DESCRIPTION:      Amylase is an enzyme produced by the pancreas to help digest carbohydrates. It is measured by a
                                blood level. Enter the blood amylase level of the organ recipient after transplant.  Enter NS to 
                                represent "No Study" if this information is not available.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,140     LIPASE POST TRANSPLANT 11;7 FREE TEXT

              Lipase Post Transplant   
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>999)!(X<1)!(X?.E1"."1.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter value of Lipase Post Transplant. 
              DESCRIPTION:      Lipase is a fat digesting enzyme. It is primarily made in the pancreas. Enter the blood lipase
                                level of the organ recipient after transplant.  Enter NS to represent "No Study" if this
                                information is not available.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,141     INSULIN REQ POST TRANSPLANT 11;8 SET

              Insulin Required Post transplant   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      MAY 20, 2008 
              HELP-PROMPT:      Enter status of Insulin Required Post Transplant. 
              DESCRIPTION:      Insulin is a hormone made by the islet cells in the pancreas. It controls sugar in the blood by
                                moving it into the cells where it can be used for energy. Indicate if insulin treatment was
                                necessary after the transplant.  


139.5,142     ORAL HYPOGLYCEMICS/POST TRANS 11;9 SET

              Oral Hypoglycemics Required Post Transplant   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      JUN 04, 2008 
              HELP-PROMPT:      Enter status of Oral Hypoglycemics Required Post Transplant. 
              DESCRIPTION:      Oral hypoglycemics are oral medications taken to lower blood glucose levels. Indicate if oral
                                hypoglycemics were administered to lower blood glucose levels after the transplant.  


139.5,143     PRA AT LISTING         .01;3 NUMBER

              PRA at Listing   
              INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1.N) X
              LAST EDITED:      APR 30, 2008 
              HELP-PROMPT:      Enter a number between 0-99 representing the PRA at Listing of organ recipient with UNOS. 
              DESCRIPTION:      Indicate the Panel Reactive Antibody of organ recipient at time of listing with UNOS. PRA
                                represents the percent of the U.S. population that the anti-human antibody in the organ recipient's
                                blood reacts with.  


139.5,144     PRA AT TRANSPLANT      .01;4 NUMBER

              PRA at Transplant   
              INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter a number between 0-99 representing the PRA at time of transplant. 
              DESCRIPTION:      Indicate the Panel Reactive Antibody of organ recipient at time of transplant. PRA represents the
                                percent of the U.S. population that the anti-human antibody in the organ recipient's blood reacts
                                with.  


139.5,145     HYPERTENSION REQUIRING MEDS .55;5 SET

              Hypertension Requiring Meds   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter status of Hypertension Requiring Meds. 
              DESCRIPTION:      Hypertension is characterized by high blood pressure repeatedly exceeding 140 over 90mm Hg - a
                                systolic pressure above 140 with a diastolic pressure above 90.  
                                 
                                For heart transplant assessments, indicate if the patient has a documented history of hypertension
                                with or without current treatment of antihypertensive medication(s).  


139.5,146     TRANSFUSION >4 RBC UNITS .55;6 SET

              Transfusion >4 RBC Units   
                                'Y' FOR YES; 
                                'N' FOR NO; 
                                'NS' FOR NO STUDY; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter YES if the patient required a transfusion of more than 4 units in 72 hours prior to surgery. 
              DESCRIPTION:      Preoperative loss of blood necessitating a minimum of 5 units of whole blood/packed red cells
                                transfused during the 72 hours prior to surgery including any blood transfused in the emergency
                                room.  


139.5,147     *DIABETES MELLITUS     .55;7 SET

              *Diabetes Mellitus   
                                'N' FOR NO; 
                                'D' FOR DIET; 
                                'O' FOR ORAL; 
                                'I' FOR INSULIN; 
              LAST EDITED:      JUL 12, 2011 
              HELP-PROMPT:      Enter status of Diabetes Mellitus. 
              DESCRIPTION:      This field has been flagged as obsolete for VASQIP. It should no longer be used.  
                                 
                                Indicate if the patient has diabetes treated with diet, oral, and/or insulin therapy. Diabetes is
                                defined as a metabolic disorder of the pancreas whereby the individual requires daily dosages of
                                exogenous parenteral insulin or an oral hypoglycemic agent to prevent a hyperglycemic/metabolic
                                acidosis. If the patient is on both Oral and Insulin therapy, indicate Insulin therapy. Indicate
                                the one most appropriate response. 
                                 
                                No - no diagnosis of diabetes. 
                                 
                                Diet - a diagnosis of diabetes that is controlled by diet alone in the 
                                       two weeks preceding surgery (the only prescribed treatment has 
                                       been diabetic relief).  
                                 
                                Oral - a diagnosis of diabetes requiring therapy with an oral 
                                       hypoglycemic agent in the two weeks preceding surgery.  
                                 
                                Insulin - a diagnosis of diabetes requiring daily insulin therapy in 
                                       the two weeks preceding surgery.  

              SCREEN:           S DIC("S")="I $$F147^SRTPUTL($G(SRTPP,DA))"
              EXPLANATION:      Screen out DIET for Lung, Liver, and Kidney

139.5,148     REOPERATION FOR BLEEDING 10;12 SET

              Reoperation for Bleeding   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter if patient required Reoperation for Bleeding. 
              DESCRIPTION:      Definition Revised (2004): Indicate if there was any re-exploration of the thorax for suspected
                                bleeding within 30 days of surgery.  


139.5,149     AMIODARONE USE         .55;8 SET

              Amiodarone Use   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter status of Amiodarone Use. 
              DESCRIPTION:      Amiodarone is an antiarrhythmic agent used for various types of tachyarrhythmias, both ventricular
                                and supraventricular arrhythmias. Indicate if the patient has a history of current or past use of 
                                Amiodarone.  


139.5,150     HEPARIN SENSITIVITY    .55;9 SET

              Heparin Sensitivity   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the status of Heparin Sensitivity. 
              DESCRIPTION:
                                Indicate if the patient has heparin sensitivity.  


139.5,151     HYPERLIPIDEMIA HISTORY .55;10 SET

              Hyperlipidemia History   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the status of Hyperlipidemia History. 
              DESCRIPTION:      Indicate if the patient has a history of elevated cholesterol, as defined as a fasting LDL level >
                                160 mg/dL, a fasting triglyceride level > 200 mg/dL, or current/past use of drugs (statins, niacin, 
                                fibrates) to treat elevated cholesterol levels.  


139.5,152     VENTRICULAR TACHYCARDIA .55;11 SET

              Ventricular Tachycardia   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the status of Ventricular Tachycardia. 
              DESCRIPTION:      Indicate if the patient had rapid beating of the heart-paroxysmal tachycardia originating in an
                                ectopic focus in the ventricle. 


139.5,153     PRIOR BLOOD TRANSFUSION .55;12 SET

              Prior Blood Transfusion   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the status of Prior Blood Transfusion. 
              DESCRIPTION:
                                Indicate if the patient has ever received a transfusion of blood and/or blood products.  


139.5,154     CREATININE ON TRANSPLANT DAY .55;13 NUMBER

              Creatinine on Day of Transplant   
              INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<.1)!(X?.E1"."2.N) X
              LAST EDITED:      JUN 30, 2008 
              HELP-PROMPT:      Enter Creatinine results. 
              DESCRIPTION:      Indicate the patient's Serum Creatinine result (mg/dl) preoperatively evaluated closest to
                                transplant surgery but not greater than 72 hours before surgery.  


139.5,155     DILATED CARDIOMYOPATHY .1;27 SET

              Dilated Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the status of Dilated Cardiomyopathy in organ recipient. 
              DESCRIPTION:      Indicate whether the patient was diagnosed with dilated cardiomyopathy (DCM) as characterized by
                                dilation and impaired contraction of one or both ventricles - generally with an ejection fraction <
                                40% 


139.5,156     CORONARY ARTERY DISEASE .11;1 SET

              Coronary Artery Disease   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the status of Coronary Artery Disease. 
              DESCRIPTION:      Indicate if patient was diagnosed with coronary plaque formation or endothelial inflammation of the
                                lining of the coronary arteries.  


139.5,157     ISCHEMIC CARDIOMYOPATHY .11;2 SET

              Ischemic Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter the Ischemic Cardiomyopathy status of the organ recipient. 
              DESCRIPTION:      Indicate if the patient was diagnosed with ischemic cardiomyopathy, primarily due to fixed or
                                non-fixed ischemic damage of the myocardium.  


139.5,158     ALCOHOLIC CARDIOMYOPATHY .11;3 SET

              Alcoholic Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the Alcoholic Cardiomyopathy status of the organ recipient. 
              DESCRIPTION:
                                Indicate if the patient was diagnosed with myocardial disease due to chronic alcoholism.  


139.5,159     VALVULAR CARDIOMYOPATHY .11;5 SET

              Valvular Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 07, 2008 
              HELP-PROMPT:      Enter the Valvular Cardiomyopathy status of the organ recipient. 
              DESCRIPTION:      Indicate if the patient was diagnosed with valvular cardiomyopathy thought to be secondary to
                                valvular disease, usually of the aortic or mitral valve.  


139.5,160     IDIOPATHIC CARDIOMYOPATHY .11;6 SET

              Idiopathic Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Idiopathic Cardiomyopathy status of the organ recipient. 
              DESCRIPTION:
                                Indicate if the patient was diagnosed with idiopathic cardiomyopathy.  


139.5,161     VIRAL CARDIOMYOPATHY   .11;7 SET

              Viral Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Viral Cardiomyopathy status of the organ recipient. 
              DESCRIPTION:      Indicate if the patient was diagnosed with viral cardiomyopathy.  Viral infection is the most
                                common cause of myocarditis and has been implicated in the development of DCM. Viruses known to
                                involve the myocardium include Coxsackievirus, Influenza virus, Adenovirus, Echovirus,
                                Cytomegalovirus, and Human Immunodeficiency Virus.  


139.5,162     PERIPARTUM CARDIOMYOPATHY .11;8 SET

              Peripartum Cardiomyopathy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the Peripartum Cardiomyopathy status of the organ recipient. 
              DESCRIPTION:      Indicate if the patient was diagnosed with cardiac failure in the period before, during, or after
                                pregnancy and delivery.  


139.5,163     PVR BEFORE VASODILATION .01;5 NUMBER

              PVR Before Vasodilation   
              INPUT TRANSFORM:  D PVR^SRTPUTL
              LAST EDITED:      MAY 19, 2008 
              HELP-PROMPT:      Enter PVR Before Vasodilation in Woods Unit. 
              DESCRIPTION:      Indicate the patient's Pulmonary Vascular Resistance measured in Woods Units before vasodilation in
                                numerical format of #.# . Entering "NS" for "No Study/Unknown" is also allowed, if not applicable
                                and PVR (wood units) after Vasodilation is obtained.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,164     PVR AFTER VASODILATION .01;6 NUMBER

              PVR After Vasodilation   
              INPUT TRANSFORM:  D PVR^SRTPUTL
              LAST EDITED:      JUN 04, 2008 
              HELP-PROMPT:      Enter PVR After Vasodilation in Woods Unit. 
              DESCRIPTION:      Indicate the patient's Pulmonary Vascular Resistance measured in Woods Units after vasodilation. 
                                Entering "NS" for "No Study/Unknown" is also allowed, if not applicable and PVR (wood units) before 
                                Vasodilation is obtained.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,165     LVEF%                  .01;7 NUMBER

              LVEF %    
              INPUT TRANSFORM:  K:+X'=X!(X>100)!(X<0)!(X?.E1"."1.N) X
              OUTPUT TRANSFORM: S Y=$S(+Y:Y_" %",1:Y)
              LAST EDITED:      MAY 14, 2008 
              HELP-PROMPT:      Enter LVEF (Left Ventricular Ejection Fraction) percentage. 
              DESCRIPTION:      Indicate the most recent pre-transplant Left Ventricular Ejection Fraction as measured by MUGA scan
                                or Echocardiogram.  


139.5,166     PRA%                   .01;8 NUMBER

              PRA %   
              INPUT TRANSFORM:  K:+X'=X!(X>100)!(X<0)!(X?.E1"."1.N) X
              OUTPUT TRANSFORM: S Y=$S(+Y:Y_" %",1:Y)
              LAST EDITED:      MAY 14, 2008 
              HELP-PROMPT:      Enter PRA (Panel Reactive Antibody) percentage. 
              DESCRIPTION:      Indicate the most recent T-cell and B-cell pre-transplant Percent Reactive Antibodies as measured
                                by flow cyometry.  


139.5,167     PA SYSTOLIC PRESSURE   0;6 FREE TEXT

              PA Systolic Pressure   
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>150)!(X<-30)!(X?.E1"."1N.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUN 18, 2008 
              HELP-PROMPT:      Enter PA Systolic Pressure from -30 to 150 mm HG. 
              DESCRIPTION:      For patients having a right heart catheterization, indicate the patient's pulmonary artery (PA)
                                systolic pressure at the catheterization most recent prior to surgery.  PA pressures obtained in
                                the operating room prior to surgery are acceptable if they are obtained prior to anesthesia
                                induction. If no right heart catheterization performed, entering "NS" for "No Study/Unknown" is 
                                also allowed.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,168     PAW MEAN PRESSURE      0;7 FREE TEXT

              PAW Mean Pressure   
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>80)!(X<-15)!(X?.E1"."1N.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUN 18, 2008 
              HELP-PROMPT:      Enter PAW Mean Pressure from -15 to 80 mm HG. 
              DESCRIPTION:      For patients having a right heart catheterization, indicate the patient's mean pulmonary artery
                                wedge (PAW) [also called pulmonary capillary] pressure or left atrial pressure measured at the 
                                catheterization most recent prior to surgery. PAW pressures obtained in the operating room prior to
                                surgery are acceptable if they are obtained prior to anesthesia induction. If no right heart or 
                                transseptal catheterization performed, entering "NS" for "No Study/Unknown" is also allowed.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,169     FEV1                   .55;14 FREE TEXT

              FEV1    
              INPUT TRANSFORM:  N SRX S SRX=X K:+X'=X!(X>9.9)!(X<1)!(X?.E1"."2.N) X S:SRX="NS"!(SRX="ns") X="NS"
              LAST EDITED:      JUN 19, 2008 
              HELP-PROMPT:      Enter value of FEV1 in Liters. 
              DESCRIPTION:      Indicate the amount of forced expiratory volume in one second from the most recent pulmonary
                                function test prior to surgery. Enter 'NS' for No Study if there has been no FEV1 measured in the
                                year preceding surgery.  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,170     DATE OF DEATH          10;19 FREE TEXT

              Date/Time of Death   
              INPUT TRANSFORM:  N SRX S SRX=X,%DT="EPT" D ^%DT S X=Y K:Y<1!(DT3 MONTHS PRIOR TO SURGERY (REMOTE SMOKER); 
              LAST EDITED:      SEP 01, 2011 
              HELP-PROMPT:      Enter Current Smoker status. 
              DESCRIPTION:      This field has been flagged as obsolete for VASQIP. It should no longer be used.  
                                 
                                Indicate the patient's smoking status from information from the patient, or the chart, that best
                                describes the patient's use of tobacco in any form (pipe, cigar, cigarette, tobacco chew).  If more 
                                than one representation is found, please record according to the most conservative (most recent)
                                quit date: 
                                 
                                1 = Never a Smoker 
                                 
                                2 = Smoking w/i 2 weeks prior to surgery 
                                 
                                3 = Smoking w/i 2 weeks to 3 months prior to surgery 
                                 
                                4 = Remote Smoker (more than 3 months prior to surgery) 


139.5,172     PRIOR MI               .55;16 SET

              Prior MI   
                                '0' FOR NONE; 
                                '1' FOR LESS THAN OR EQUAL 7 DAYS OF SURG; 
                                '2' FOR GREATER THAN 7 DAYS PRIOR TO SURG; 
              LAST EDITED:      AUG 11, 2008 
              HELP-PROMPT:      Enter the category that most accurately reflects the patient's most recent Myocardial Infarction. 
              DESCRIPTION:      Indicate whether the patient has a history of a non-Q-wave or Q-wave myocardial infarction as
                                diagnosed in his or her medical records. Myocardial infarction may be indicated by the presence of
                                one of the following: 1) typical rise and fall in biochemical markers, 2) cardiac pain, 3) typical
                                ECG changes (new Q-waves, ST segment elevation or depression). In the absence of the above
                                supporting data, a clear statement or diagnosis of prior myocardial infarction in the chart will
                                suffice; however, the patient's statement, "I've had a heart attack" is insufficient evidence.
                                Indicate the one appropriate response: 
                                 
                                None - The patient has never had a previous Myocardial Infarction.  
                                 
                                <=7 days of surg - The patient had a previous Myocardial Infarction 
                                    within 7 days prior to surgery.  
                                 
                                >7 days prior to surg - The patient had a Myocardial Infarction more 
                                   than 7 days prior to surgery." 
                                 
                                The field for PRIOR MI shall be added to the data entry option for Non-VA heart transplant
                                assessments.  


139.5,173     NUM OF PRIOR HEART SURGERIES .55;17 SET

              Number of Prior Heart Surgeries   
                                '0' FOR None; 
                                '1' FOR 1; 
                                '2' FOR 2; 
                                '3' FOR 3; 
                                '>' FOR >3; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Enter Number of Prior Heart Surgeries. 
              DESCRIPTION:      Indicate the number of previous heart surgeries the patient has had upon current admission, by
                                referencing the patient history.  The prior heart surgery/ies would have occurred during a separate 
                                hospitalization (more than 30 days prior to current surgery).  Both on and off-pump cardiac
                                surgical procedures should be considered.  Count all surgical procedures performed during separate
                                hospital admissions (not the number of grafts, and not additional procedures performed during the
                                same admission due to a postoperative occurrence). Indicate the one appropriate response: 0, 1, 2,
                                3, >3.  


139.5,174     *CEREBRAL VASCULAR DISEASE .55;18 SET

              *Cerebral Vascular Disease   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 20, 2011 
              HELP-PROMPT:      Enter status of Cerebral Vascular Disease. 
              DESCRIPTION:      This field has been flagged as obsolete for VASQIP. It should no longer be used.  
                                 
                                Indicate if the patient has cerebral vascular disease, defined as disease of the arteries to the
                                head manifested by previous stroke (cerebral vascular accident), and/or transient ischemic attack
                                (TIA), and/or prior surgical repair (e.g., carotid endarterectomy), and/or greater than or equal to
                                50% obstruction of luminal diameter documented by contrast angiography or duplex ultrasound
                                examination.  (NOTE: Stroke should be broadly interpreted to include intracerebral or subarachnoid
                                bleeding.) 


139.5,175     CONGESTIVE HEART FAILURE .55;19 SET

              Congestive Heart Failure (CHF)   
                                '1' FOR Class I; 
                                '2' FOR Class II; 
                                '3' FOR Class III; 
                                '4' FOR Class IV; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter class of Congestive Heart Failure (NYHA Functional Class). 
              DESCRIPTION:      Indicate whether the patient has congestive heart failure if the patient chart or patient
                                self-report indicates a history of congestive heart failure within the 30 days before surgery. 
                                Congestive heart failure is defined as the inability of the heart to pump a sufficient quantity of
                                blood to meet the metabolic needs of the body or can do so only at increased ventricular filling 
                                pressure. Common manifestations are identified: 
                                 
                                From the history: 1) Abnormal limitation in exercise tolerance due to dyspnea, fatigue 
                                   or angina.  
                                 
                                2) Orthopnea (dyspnea on lying supine).  
                                 
                                3) Paroxysmal nocturnal dyspnea (PND) - awakening from sleep with 
                                   dyspnea which is relieved by assuming an upright posture).  
                                 
                                From the physical examination: 4) Increased jugular venous pressure.  
                                 
                                5) Pulmonary rales on physical examination.  
                                 
                                From the chest x-ray: 6) Cardiomegaly, and 
                                 
                                7) Pulmonary vascular engorgement. 
                                 
                                The New York Heart Association functional classification is commonly used as a subjective
                                assessment of the severity of congestive heart failure. If none of the above manifestations have
                                been present or congestive heart failure is not mentioned as an active problem in the 30 days
                                before surgery, indicate Class I.  Any mention of above manifestations requires the indication of a
                                stage other than Class I.  Indicate the one most appropriate response: 
                                 
                                Class I - cardiac disease, no symptoms of abnormal fatigue, dyspnea, 
                                      or angina.  
                                 
                                Class II - slight limitation of physical activity by fatigue, dyspnea 
                                      , or angina. The patient gets unusual fatigue, dyspnea, and/or 
                                      angina only upon performing more strenuous activities, such as 
                                      climbing two or more flights of stairs without stopping.  
                                 
                                Class III - marked limitation of physical activity by fatigue, 
                                      dyspnea, or angina. The patient gets unusual fatigue, dyspnea, 
                                      and/or angina upon performing ordinary activities, such as 
                                      walking several blocks or climbing a flight of stairs.  
                                 
                                Class IV - symptoms at rest and/or inability to carry out any 
                                      physical activity without symptoms of fatigue, dyspnea or 
                                      angina. The patient has symptoms of unusual fatigue, dyspnea, 
                                      and/or angina at rest or when performing minimal activity, 
                                      such as walking across the room.  


139.5,176     IV NTG WITHIN 48 HOURS .55;20 SET

              IV NTG within 48 Hours   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Did patient receive intravenous (IV) nitroglycerin (NTG) within 48 hours preceding surgery? 
              DESCRIPTION:      Indicate if the patient was administered nitroglycerin intravenously within 48 hours prior to
                                surgery.  


139.5,177     CURRENT DIGOXIN USE    .55;21 SET

              Current Digoxin Use   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter status of Current Digoxin Use. 
              DESCRIPTION:      Indicate if the patient has used a digitalis preparation (digoxin, Lanoxin, digitoxin, etc.) within
                                the two weeks prior to surgery. 


139.5,178     CURRENT DIURETIC USE   .55;22 SET

              Current Diuretic Use   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter status of Current Diuretic Use. 
              DESCRIPTION:
                                Indicate if the patient has used any diuretic preparation within the two weeks prior to surgery.  


139.5,179     PREOP CIRCULATORY DEVICE .55;23 SET

              Preoperative Circulatory Device   
                                'N' FOR NONE; 
                                'I' FOR IABP; 
                                'V' FOR VAD; 
                                'A' FOR ARTIFICIAL HEART; 
                                'O' FOR OTHER; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Enter status of Preoperative Use of New Mechanical Circulatory Device within 2 Weeks of Surgery. 
              DESCRIPTION:      Indicate whether there was any use of any device to assist ventricular function at the time the
                                patient presents for surgery.  Indicate the one appropriate response: 
                                 
                                None - No New Mechanical Circulatory Device was placed.  
                                 
                                IABP - An intra-aortic balloon pump was placed to assist ventricular 
                                       function.  
                                 
                                VAD - A ventricular assist device (e.g., LVAD, BIVAD) was placed to 
                                      assist ventricular function.  
                                 
                                Artificial Heart - An artificial heart was placed to assist ventricular 
                                      function.  
                                 
                                Other - Another type of Mechanical Circulatory Device was placed.  


139.5,181     ASSESSMENT STATUS      RA;1 SET

              Assessment Status   
                                'I' FOR INCOMPLETE; 
                                'C' FOR COMPLETE; 
                                'T' FOR TRANSMITTED; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter the current status of this transplant assessment. 
              DESCRIPTION:      This is the current status of the surgery risk  assessment.  When creating a new assessment, the
                                status will automatically be entered as 'INCOMPLETE'.  Upon completion of the assessment, this
                                field will be updated to 'COMPLETED'.  After the assessment is transmitted, this field will be
                                automatically updated to 'TRANSMITTED'.  

              RECORD INDEXES:   AF (#549)

139.5,182     TRANSPLANT TYPE        RA;2 SET

              Transplant Type   
                                'K' FOR KIDNEY; 
                                'LI' FOR LIVER; 
                                'LU' FOR LUNG; 
                                'H' FOR HEART; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      The Transplant Type is the name of the organ transplanted. 
              DESCRIPTION:      The Transplant Type is the name of the organ transplanted. This field only allows selection of
                                KIDNEY, LIVER, LUNG, or HEART.  

              RECORD INDEXES:   AF (#549)

139.5,183     RE-TRANSMISSION        RA;3 SET

              Re-Transmission   
                                '0' FOR NOT RE-TRANSMITTED; 
                                '1' FOR RE-TRANSMITTED; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter 1 if this assessment will be re-transmitted. 
              DESCRIPTION:      This determines whether the assessment will be  re-transmitted.  It will automatically be set to
                                '1' when a transmitted assessment is updated to an INCOMPLETE status to edit and re-transmit.  


139.5,184     DATE TRANSMITTED       RA;4 DATE

              Date Transmitted   
              INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
              LAST EDITED:      FEB 25, 2008 
              HELP-PROMPT:      Enter the Date that this Assessment was transmitted. 
              DESCRIPTION:
                                This is the date (or date/time) that this surgery risk assessment was transmitted.  


139.5,185     VA/NON VA INDICATOR    RA;5 SET (Required)

              VA or Non-VA Indicator   
                                'V' FOR VA; 
                                'N' FOR NON-VA; 
              LAST EDITED:      JUL 08, 2008 
              HELP-PROMPT:      Indicate whether the transplant was performed in a VA or Non-VA facility. 
              DESCRIPTION:
                                This field indicates whether the transplant was performed in VA facility or Non-VA facility.  


139.5,187     DATE STARTED DIALYSIS  .01;1 FREE TEXT

              Date Started Dialysis   
              INPUT TRANSFORM:  N SRX S SRX=X,%DT="EP" D ^%DT S X=Y K:Y<1 X S:SRX="NS"!(SRX="ns") X="NS"
              OUTPUT TRANSFORM: S Y(0)=Y D DATE^SROAUTL
              LAST EDITED:      AUG 27, 2008 
              HELP-PROMPT:      Enter the date patient began dialysis. 
              DESCRIPTION:      Indicate date that patient began renal replacement therapy due to renal failure. System will also
                                accept an entry for NS (No Study).  

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER


139.5,188     DATE OF LAST TRANSMISSION RA;8 DATE

              INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:X<1 X
              LAST EDITED:      MAY 22, 2008 
              HELP-PROMPT:      (No range limit on date) 
              DESCRIPTION:      This is the date of the retransmission if this assessment has been retransmitted to the national
                                database. If there was no retransmission of this assessment, this is the date of the original 
                                transmission.  

              CROSS-REFERENCE:  139.5^AT^MUMPS 
                                1)= D AT^SRTPUTL
                                2)= D KAT^SRTPUTL
                                This MUMPS type cross-reference is used for sorting transmitted assessed cases and excluded cases
                                by the DATE OF LAST TRANSMISSION field.   



139.5,189     TRACHEOSTOMY           10;14 SET

              Tracheostomy   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      JUL 09, 2008 
              HELP-PROMPT:      Enter status of Tracheostomy for organ recipient. 
              DESCRIPTION:      Indicate if a procedure to cut into the trachea and insert a tube to overcome tracheal obstruction
                                or to facilitate extended mechanical ventilation was performed within 30 days postoperatively.  


139.5,190     MEDIASTINITIS          10;15 SET

              Mediastinitis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter status of Mediastinitis for organ recipient. 
              DESCRIPTION:      Indicate if the patient developed a bacterial infection involving the sternum or deep to the
                                sternum requiring drainage and anti-microbial therapy diagnosed within 30 days after surgery.  


139.5,191     RENAL FAILURE REQ. DIALYSIS 10;16 SET

              Renal Failure Requiring Dialysis   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      AUG 31, 2011 
              HELP-PROMPT:      Enter YES if the patient has acute renal failure. 
              DESCRIPTION:      VASQIP Definition (2011): Indicate if the patient developed new renal failure requiring renal
                                replacement therapy or experienced an exacerbation of preoperative renal failure requiring
                                initiation of renal replacement therapy (not on renal replacement therapy preoperatively) within 30
                                days postoperatively.  Renal replacement therapy is defined as venous to venous hemodialysis
                                [CVVHD], continuous venous to arterial hemodialysis [CVAHD], peritoneal dialysis, hemofiltration,
                                hemodiafiltration or ultrafiltration.  
                                 
                                TIP: If the patient refuses dialysis, report as an occurrence because he/she did require dialysis.  


139.5,192     PERIOPERATIVE MI       10;17 SET

              Perioperative MI   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      AUG 31, 2011 
              HELP-PROMPT:      Enter YES if the patient has had a myocardial infarction. 
              DESCRIPTION:      VASQIP Definition (2011): Indicate the presence of a peri-operative MI that occurs either 
                                intraoperatively or postoperatively within 30 days: 
                                 
                                Non-Cardiac Surgery: A new transmural acute myocardial infarction as manifested by new Q-waves on
                                ECG. (Non-Q-wave infarctions should be entered under "Other Occurrence").  
                                 
                                Cardiac Surgery: A new transmural acute myocardial infarction as manifested by at least one of the
                                following criteria:  1. Development of new Q-waves in two or more contiguous ECG leads; 2.
                                Evolutionary ST-segment elevations; 3. New or presumably new LBBB pattern on the ECG.  


139.5,193     OPERATIVE DEATH        10;18 SET

              Operative Death   
                                'Y' FOR YES; 
                                'N' FOR NO; 
              LAST EDITED:      APR 08, 2008 
              HELP-PROMPT:      Indicate if patient died within 30 days of transplant surgery. 
              DESCRIPTION:      Indicate if the patient died within the 30 days after surgery in or out of the hospital regardless
                                of cause; or within the index hospitalization regardless of cause; or patient died greater than 30 
                                days as a direct result of a perioperative occurrence of the surgery (e.g., mediastinitis).  


139.5,197     PLASMAPHERESIS         .01;2 SET

              Plasmapheresis   
                                '1' FOR BEFORE TRANSPLANT; 
                                '2' FOR AFTER TRANSPLANT ; 
                                '3' FOR BOTH; 
                                '4' FOR NO; 
              LAST EDITED:      APR 09, 2008 
              HELP-PROMPT:      Enter the status of Plasmapheresis treatment for organ recipient. 
              DESCRIPTION:      Plasmapheresis is the procedure of removing, treating, and returning of plasma from blood
                                circulation. It is an extracorporeal therapy.  


139.5,198     TOBACCO USE            .55;24 SET

              Tobacco Use   
                                '1' FOR NEVER USED TOBACCO; 
                                '2' FOR NO USE IN LAST 12 MOS; 
                                '3' FOR CIGARETTES ONLY; 
                                '4' FOR OTHER (NO CIGARETTES); 
                                '5' FOR CIGARETTES PLUS OTHER; 
              LAST EDITED:      SEP 23, 2011 
              HELP-PROMPT:      Indicate the patient's type of tobacco product used in the 12 months prior to surgery. 
              DESCRIPTION:      VASQIP Definitions (2011): Indicate the patient's type of tobacco product used in the 12 months  
                                prior to surgery. Select one: 
                                 1 = Never used tobacco 
                                 2 = No tobacco use in the last 12 months 
                                 3 = Cigarettes only 
                                 4 = Pipe, cigar, snuff, or chewing tobacco only (no cigarettes) 
                                 5 = Cigarettes plus one or more of pipe, cigar, snuff, or chewing 
                                     tobacco 

              CROSS-REFERENCE:  ^^TRIGGER^139.5^199 
                                1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^SRT(D0,.55)):^(.55),1:"") S X=$P(Y(1),U,25),X=X S D
                                IU=X K Y S X=DIV S X=$S(X<3:"NA",1:"") S DIH=$G(^SRT(DIV(0),.55)),DIV=X S $P(^(.55),U,25)=DIV,DIH=1
                                39.5,DIG=199 D ^DICR

                                2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^SRT(D0,.55)):^(.55),1:"") S X=$P(Y(1),U,25),X=X S D
                                IU=X K Y S X="" S DIH=$G(^SRT(DIV(0),.55)),DIV=X S $P(^(.55),U,25)=DIV,DIH=139.5,DIG=199 D ^DICR

                                CREATE VALUE)= S X=$S(X<3:"NA",1:"")
                                DELETE VALUE)= @
                                FIELD)= TOBACCO USE TIMEFRAME
                                Trigger to set the TOBACCO USE TIMEFRAME field (#199) to "NA" for NOT APPLICABLE if the TOBACCO USE
                                field (#198) is set to a value less than 3.  



139.5,199     TOBACCO USE TIMEFRAME  .55;25 SET

              Tobacco Use Timeframe   
                                '1' FOR WITHIN 2 WEEKS; 
                                '2' FOR 2 WKS TO 3 MOS; 
                                '3' FOR 3 TO 12 MONTHS; 
                                'NA' FOR NOT APPLICABLE; 
              INPUT TRANSFORM:  D CHK199^SRTPUTL
              LAST EDITED:      AUG 16, 2011 
              HELP-PROMPT:      Indicate the timeframe of tobacco use prior to surgery. 
              DESCRIPTION:      VASQIP Definitions (2011): If the patient used tobacco products in the 12 months prior to surgery,
                                indicate the timeframe: 
                                 1 = within the 2 weeks prior to surgery 
                                 2 = between 2 weeks and 3 months prior to surgery 
                                 3 = between 3 months and 12 months prior to surgery 

              NOTES:            XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
                                TRIGGERED by the TOBACCO USE field of the SURGERY TRANSPLANT ASSESSMENTS File 


139.5,200     DIABETES MELLITUS CHRONIC .55;26 SET

              Diabetes Mellitus: Chronic, Long-term Management   
                                '1' FOR NO; 
                                '2' FOR DIET; 
                                '3' FOR ORAL; 
                                '4' FOR INSULIN; 
              LAST EDITED:      SEP 23, 2011 
              HELP-PROMPT:      Enter appropriate code for chronic, long-term Diabetes Mellitus management. 
              DESCRIPTION:      VASQIP Definitions (2011): Indicate the chronic, long-term treatment regimen for patients with a 
                                diagnosis of Diabetes Mellitus. Diabetes Mellitus is defined as a metabolic disorder of the
                                pancreas whereby the individual requires diet modification, daily dosages of exogenous parenteral
                                insulin or an oral hypoglycemic agent to prevent a hyperglycemic/metabolic acidosis.  If the
                                patient is on both Oral and Insulin therapy, indicate Insulin therapy. 
                                 
                                 No - no diagnosis of diabetes 
                                 Diet - a diagnosis of diabetes that is controlled by diet alone 
                                 Oral - a diagnosis of diabetes requiring therapy with an oral 
                                        hypoglycemic agent 
                                 Insulin - a diagnosis of diabetes requiring daily insulin therapy 


139.5,201     DIABETES MELLITUS PREOP MGMT .55;27 SET

              Diabetes Mellitus: Management Prior to Surgery   
                                '1' FOR NO; 
                                '2' FOR DIET; 
                                '3' FOR ORAL; 
                                '4' FOR INSULIN; 
              LAST EDITED:      SEP 23, 2011 
              HELP-PROMPT:      Enter appropriate code for management of Diabetes Mellitus in the two weeks prior to surgery. 
              DESCRIPTION:      VASQIP Definitions (2011): Indicate the treatment regimen for patients with a diagnosis of Diabetes
                                Mellitus in the two weeks prior to surgery. Diabetes Mellitus is defined as a metabolic disorder of
                                the pancreas whereby the individual requires diet modification, daily dosages of exogenous 
                                parenteral insulin or an oral hypoglycemic agent to prevent a hyperglycemic/metabolic acidosis. If
                                the patient is on both Oral and Insulin therapy, indicate Insulin therapy.  
                                 
                                 No - no diagnosis of diabetes 
                                 Diet - a diagnosis of diabetes that is controlled by diet alone in the 
                                        two weeks preceding surgery 
                                 Oral - a diagnosis of diabetes requiring therapy with an oral 
                                        hypoglycemic agent in the two weeks preceding surgery 
                                 Insulin - a diagnosis of diabetes requiring daily insulin therapy in 
                                        the two weeks preceding surgery 


139.5,202     CVD REPAIR/OBSTRUCTION .55;28 SET

              Prior Surgical Repair/Carotid Artery Obstruction   
                                '0' FOR NO CVD; 
                                '1' FOR YES - NO SURGICAL REPAIR; 
                                '2' FOR YES - PRIOR SURGICAL REPAIR; 
              LAST EDITED:      SEP 23, 2011 
              HELP-PROMPT:      Enter value of 0-2 to indicate CVD. 
              DESCRIPTION:      VASQIP Definitions (2011): Select one of the following if patient has indication of Cerebrovascular
                                Disease (CVD): 
                                 0 = No CVD indication 
                                 1 = Yes, CVD indication by documented obstruction of carotid artery 
                                     luminal diameter greater than or equal to 50% obstruction of the 
                                     carotid artery documented by contrast angiography or duplex 
                                     ultrasound examination which did not result in surgical repair 
                                 2 = Yes, CVD indication resulting in prior carotid artery surgical 
                                     repair (e.g., carotid endarterectomy or stenting) 


139.5,203     HISTORY OF CVD         .55;29 SET

              History of CVD Events   
                                '0' FOR NO CVD; 
                                '1' FOR HISTORY OF TIA'S; 
                                '2' FOR CVA/STROKE - NO NEURO DEFICIT; 
                                '3' FOR CVA/STROKE W/ NEURO DEFICIT; 
              LAST EDITED:      SEP 23, 2011 
              HELP-PROMPT:      Enter value of 0-3 to indicate if the patient has history of CVD events. 
              DESCRIPTION:      VASQIP Definitions (2011): Indicate if the patient has a history of cerebrovascular accident by 
                                selecting one of the following indications:  (If multiple events, select the one with greatest
                                severity.): 
                                 
                                 0 = No CVD 
                                 
                                 1 = History of Transient Ischemic Attacks: Transient ischemic attacks 
                                     (TIAs) are focal neurologic deficits (e.g. numbness of an arm or 
                                     amaurosis fugax) of sudden onset and brief duration (usually <30 
                                     minutes ), which usually reflect dysfunction in a cerebral vascular 
                                     distribution.  
                                     These attacks may be recurrent and, at times, may precede a stroke.  
                                 
                                 2 = CVA/Stroke with no neurological deficit: History of 
                                     a cerebrovascular accident (embolic, thrombotic, or hemorrhagic) 
                                     with neurologic deficit(s) lasting at least 30 minutes, but no 
                                     current residual neurologic dysfunction or deficit 
                                 
                                 3 = CVA/Stroke with neurological deficit: History of a cerebrovascular 
                                     accident (embolic, thrombotic, or hemorrhagic) with persistent 
                                     residual motor, sensory, or cognitive dysfunction (e.g., 
                                     hemiplegia, hemiparesis, aphasia, sensory deficit, impaired memory) 



      FILES POINTED TO                      FIELDS

INSTITUTION (#4)                  DIVISION (#63)

PATIENT (#2)                      PATIENT (#.01)

SURGERY (#130)                    SURGERY CASE (#2)


File #139.5

  Record Indexes:

  AD (#547)    RECORD    MUMPS    IR    ACTION
      Short Descr:  Auto-populate the TOTAL ISCHEMIA TIME FOR ORGAN field (#89). 
      Description:  This cross-reference is to auto-populate TOTAL ISCHEMIA TIME FOR ORGAN field (#89) based on what was entered
                    for Warm and Cold Ischemia fields.  The Total Ischemia is the sum of warm ischemia time and cold ischemia time.  
        Set Logic:  S $P(^SRT($S($D(SRTPP):SRTPP,1:DA),3),"^",6)=X2(1)+X2(2)
         Set Cond:  S X=(X2(1)'="")&(X2(2)'="")
       Kill Logic:  Q
        Kill Cond:  S X=0
       Whole Kill:  Q
             X(1):  WARM ISCHEMIA TIME FOR ORGAN  (139.5,85)  (forwards)
             X(2):  COLD ISCHEMIA TIME FOR ORGAN  (139.5,87)  (forwards)

  AE (#548)    RECORD    REGULAR    IR    SORTING ONLY
      Short Descr:  This is a sort only index of the VACO ID & PATIENT fields.
        Set Logic:  S ^SRT("AE",X(1),X(2),DA)=""
       Kill Logic:  K ^SRT("AE",X(1),X(2),DA)
       Whole Kill:  K ^SRT("AE")
             X(1):  VACO ID  (139.5,3)  (Subscr 1)  (forwards)
             X(2):  PATIENT  (139.5,.01)  (Subscr 2)  (forwards)

  AF (#549)    RECORD    REGULAR    IR    SORTING ONLY
      Short Descr:  This is a sort index of the TRANSPLANT TYPE, ASSESSMENT STATUS & DFN
      Description:  This cross reference lists transplant assessments according to their type, their assessment status, the
                    patient's DFN and the internal entry number (IEN) in the SURGERY TRANSPLANT ASSESSMENTS file (#139.5). This 
                    cross reference is used by the transmission routine SRTPMIT to identify which transplant assessments are
                    COMPLETE and thus ready for transmission. The cross reference list of assessments is updated when the 
                    ASSESSMENT STATUS field (#181) is changed.  
        Set Logic:  S ^SRT("AF",X(1),X(2),X(3),DA)=""
         Set Cond:  S X=(X(1)'="")
       Kill Logic:  K ^SRT("AF",X(1),X(2),X(3),DA)
        Kill Cond:  S X=(X(1)'="")
       Whole Kill:  K ^SRT("AF")
             X(1):  TRANSPLANT TYPE  (139.5,182)  (Subscr 1)  (forwards)
             X(2):  ASSESSMENT STATUS  (139.5,181)  (Subscr 2)  (forwards)
             X(3):  PATIENT  (139.5,.01)  (Subscr 3)  (forwards)


INPUT TEMPLATE(S):

PRINT TEMPLATE(S):

SORT TEMPLATE(S):

FORM(S)/BLOCK(S):