Donor Abstract
| IDENTIFICATION NO RR 371 | DATE 05/2007 | ||||
PHYSICAL AND PERSONAL CHARACTERISTICS |
|||||
| DOB (M/Y) 11/81 | Place of Birth: Louisiana | ||||
| HEIGHT 5'10" | WEIGHT 200 | ||||
| EYE COLOR Blue | COMPLEXION Fair | ||||
| HAIR Light Brown, Straight | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Catholic | MARRIED No | NO. OF CHILDREN 0 | |||
| YRS OF COLLEGE 4 | OCCUPATION Professional Musician | HERITAGE Scottish, Spanish, Italian | |||
| INTERESTS music | |||||
|
TEST RESULTS |
|||||
| Blood Type O positive | HIV 1/2 Ab. & HIV 1 Ag. Nonreactive | ||||
| Chlamydia Nonreactive | HTLV-1 Ab. Nonreactive | ||||
| Chromosome analysis Normal Male 46XY | Neisseria gonorrhea Nonreactive | ||||
| CMV, IgG Nonreactive | SGPT within normal limits | ||||
| Cystic Fibrosis Negative for 70 mutations | Sickle cell Not Applicable | ||||
| Group B streptococcus not applicable | 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 |
Grandfather had heart attack; Father has high blood pressure (problem alleviated by weight reduction) | |||
BLOOD |
None | None | |||
| RESPIRATORY | None | None | |||
| GASTROINTESTINAL | None | None | |||
| METABOLIC/ENDOCRINE | None | Father has adult onset diabetes (controlled with weight loss); Aunt with diabetes | |||
| URINARY | None | None | |||
| GENITAL/REPRODUCTIVE SYSTEM | None | None | |||
| NEUROLOGICAL | None | None | |||
| MENTAL HEALTH | None | None | |||
| MUSCLES/BONES/JOINTS | None | Grandparent had arthritis late in life | |||
| SIGHT/SOUND/SMELL | Donor had deviated septum | None | |||
| SKIN | None | Aunt has skin cancer (melanoma) | |||
| OTHER | None | Grandfather was alcoholic; Uncle abused drugs | |||
|
FAMILY HISTORY |
|||||
| LEVEL OF SCHOOLING: | Mother High School | Father High School | |||
| OCCUPATION: | Mother Teacher | Father Executive in building supply | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 49 | ||||
| FATHER | 54 | ||||
| MATERNAL GRANDFATHER | 73 | Natural causes (heart related) | |||
| MATERNAL GRANDMOTHER | 65 | Natural causes (heart related) | |||
| PATERNAL GRANDFATHER | 53 | Heart Attack | |||
| PATERNAL GRANDMOTHER | 81 | ||||
| BROTHERS | 17 | ||||
| SISTERS | 28 | ||||