Donor Abstract

IDENTIFICATION NO RR 295 DATE 01/2000     

 PHYSICAL AND PERSONAL CHARACTERISTICS

DOB (M/Y) 07/71 PLACE OF BIRTH Massachusetts
HEIGHT 5'10" WEIGHT 160
EYE COLOR Blue COMPLEXION Fair
HAIR Light Brown, Straight RIGHT HANDED   LEFT HANDED X
RELIGION BORN INTO Protestant MARRIED No NO. OF CHILDREN 1
YRS OF COLLEGE 4 OCCUPATION Mechanical Engineer HERITAGE German, Irish, British
INTERESTS     sports, academics 

 TEST RESULTS

Blood Type A Positive HIV 1/2 Ab. & HIV 1 Ag.  Nonreactive
Chlamydia Negative by PCR HTLV-1 Ab. Nonreactive
Chromosome analysis Normal Male 46XY  Neisseria gonorrhea None isolated
CMV, IgG Nonreactive SGPT Within Normal Limits
Cystic Fibrosis Negative for 33 mutations Sickle cell Not Applicable
Group B streptococcus Negative Syphilis, antibody Nonreactive
HbsAg & HbcAb Nonreactive Tay Sachs Not Applicable
Hepatitis C, Ab Nonreactive Thalassemia Normal Adult Hemoglobin
Trichomonas & yeast None present  

 DONOR AND FAMILY HEALTH HISTORY

MEDICAL PROBLEM DONOR RELATIVE

HEART

None

Grandparent -- high blood pressure, stroke in 70's

BLOOD

None None
RESPIRATORY None None
GASTROINTESTINAL None None
METABOLIC/ENDOCRINE None None
URINARY None   None 
GENITAL/REPRODUCTIVE SYSTEM None  None
NEUROLOGICAL None Grandparent -- early signs of Alzheimers in 70's; Mother -- migraines started in 40's
MENTAL HEALTH None  None
MUSCLES/BONES/JOINTS None None
SIGHT/SOUND/SMELL None  None
SKIN None  None
OTHER None None

 FAMILY HISTORY

LEVEL OF SCHOOLING: Mother Associates Degree Father High School
OCCUPATION: Mother Educator Father Sales
 
  AGE IF LIVING AGE AT DEATH CAUSE OF DEATH
MOTHER 54
FATHER 56
MATERNAL GRANDFATHER  mid-late 70's  
MATERNAL GRANDMOTHER mid-late 70's  
PATERNAL GRANDFATHER mid-late 70's
PATERNAL GRANDMOTHER mid-late 70's
BROTHERS 34    
SISTERS 32, 28    

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