Donor Abstract 

IDENTIFICATION NO. RR355 DATE 11/03

 

 PHYSICAL AND PERSONAL CHARACTERISTICS
DOB (M/Y) 02/1983 PLACE OF BIRTH  Florida
HEIGHT 6'0" WEIGHT 185
EYE COLOR  Blue COMPLEXION Medium
HAIR Dark Brown, Straight RIGHT HANDED  X LEFT HANDED
RELIGION BORN INTO Unitarian MARRIED No NO. OF CHILDREN 0
YRS OF COLLEGE 3 OCCUPATION Philosophy Major HERITAGE Irish, English
INTEREST Computer games, Running, Working out

 

 TEST RESULTS

 
Blood Type B Negative 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 ALT Negative
Cystic Fibrosis Noncarrier 37 mutations Sickle cell Not Applicable
HbsAg & HbcAb Nonreactive Syphilis, antibody Nonreactive
Hepatitis C, Ab Nonreactive Tay Sachs & Canavan Not Tested
Thalassemia Normal Adult Hemoglobin HIV-1/HCV RNA  Nonreactive

 

DONOR AND FAMILY HEALTH HISTORY

 
MEDICAL PROBLEM DONOR RELATIVE

HEART

None

 Maternal Grandmother - High blood pressure and heart attack

BLOOD

 None None
RESPIRATORY None Brother - 
Asthma as a child 
GASTROINTESTINAL None None
METABOLIC/ENDOCRINE None Grandfather - Diabetic
URINARY None Cousin - Kidney reflex at birth
GENITAL/REPRODUCTIVE SYSTEM None None
NEUROLOGICAL None Aunt - had siezures as a child, none afterward
MENTAL HEALTH None Maternal Grandfather - diagnosed as paranoid schizophrenic at 35 (one hospitalization)
MUSCLES/BONES/JOINTS None None
SIGHT/SOUND/SMELL None None
SKIN None 2 Grandparents have a few lesions
OTHER None Paternal Grandfather - Alcoholism and father had bouts of heavy drinking

 

 FAMILY HISTORY

 
LEVEL OF SCHOOLING: Mother MA Father  BS
OCCUPATION: Mother Educator Father Law enforcement
 
  AGE IF LIVING AGE AT DEATH CAUSE OF DEATH
MOTHER 50       
FATHER 53      
MATERNAL GRANDFATHER 72 Heart attack
MATERNAL GRANDMOTHER 71      
PATERNAL GRANDFATHER    43 Alcoholism
PATERNAL GRANDMOTHER 77      
BROTHERS 26      
SISTERS 24      

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