Donor Abstract
| IDENTIFICATION NO. RR352 | DATE 11/02 | ||||
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PHYSICAL AND PERSONAL CHARACTERISTICS |
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| DOB (M/Y) 04/1981 | PLACE OF BIRTH Louisiana | ||||
| HEIGHT 6'3" | WEIGHT 165 | ||||
| EYE COLOR Blue | COMPLEXION Fair | ||||
| HAIR Brown, Curly | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Roman Catholic | MARRIED No | NO. OF CHILDREN 0 | |||
| YRS OF COLLEGE 4 | OCCUPATION Engineering Major | HERITAGE English, French | |||
| INTEREST Weight lifting, Racquetball, and guitar | |||||
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TEST RESULTS |
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| Blood Type A Positive | HIV 1/2 Ab. & HIV 1 Ag. Nonreactive | ||||
| Chlamydia Negative | HTLV-1,2 Ab. Nonreactive | ||||
| Chromosome analysis 46, XY | Neisseria gonorrhea Negative | ||||
| CMV IgG Nonreactive | SGPT Normal | ||||
| Cystic Fibrosis 37 Common Mutations - Negative | Sickle cell Not Applicable | ||||
| Group B streptococcus Negative | Syphilis, antibody Nonreactive | ||||
| HbsAg & HbcAb Nonreactive | Tay Sachs & Canavan Not Tested | ||||
| Hepatitis C, Ab Nonreactive | Thalassemia Normal Adult Hemoglobin | ||||
| Trichomonas & yeast Not Present | HIV-1/HCV RNA Nonreactive | ||||
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DONOR AND FAMILY HEALTH HISTORY
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| MEDICAL PROBLEM | DONOR | RELATIVE | |||
| HEART |
None |
Mother and maternal grandfather - High blood pressure | |||
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BLOOD |
None | None | |||
| RESPIRATORY | Mild asthma | Mother - mild asthma | |||
| GASTROINTESTINAL | None | Father - ulcer Grandmother - survived colon cancer | |||
| METABOLIC/ENDOCRINE | None | Paternal Grandfather - diabetes | |||
| URINARY | None | None | |||
| GENITAL/REPRODUCTIVE SYSTEM | None | None | |||
| NEUROLOGICAL | None | None | |||
| MENTAL HEALTH | None | None | |||
| MUSCLES/BONES/JOINTS | None | Maternal Uncle - muscular dystrophy | |||
| SIGHT/SOUND/SMELL | None | None | |||
| SKIN | Mild acne (non-scarring) | Mother - mild acne (non-scarring) | |||
| OTHER | None | None | |||
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FAMILY HISTORY
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| LEVEL OF SCHOOLING: | Mother High school | Father High school | |||
| OCCUPATION: | Mother Homemaker | Father Foreman/Industry | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 44 | ||||
| FATHER | 50 | ||||
| MATERNAL GRANDFATHER | 64 | Gunshot victim | |||
| MATERNAL GRANDMOTHER | 65 | ||||
| PATERNAL GRANDFATHER | 75 | ||||
| PATERNAL GRANDMOTHER | 50's | Blood clot | |||
| BROTHERS | None | ||||
| SISTERS | 15 | ||||