Organ Offer Review/Acceptance Note

Date/Time Created: [date/time] (Use 24-hour format with time zone.)

Author/Role: [author name, credentials, role]

Attending of Record: [attending name, credentials]

Recipient: [name, MRN, DOB, current location]

Organ Program: [Kidney / Liver / Heart / Lung / Multi-organ]

Donor ID / Offer ID: [donor ID]; [offer ID]

OPO: [organ procurement organization name]

Key Timestamps: Offer notification [date/time]; Acceptance decision [date/time]; Recipient notification [date/time] (Include only those applicable.)

Offer Summary

• [Organ(s) offered with laterality]
• [Donor type: DBD / DCD]; [cause of death]
• [ABO compatibility: donor ABO → recipient ABO, compatible / intended incompatible]
• [Immunologic risk: cPRA %, virtual crossmatch status, DSA status if relevant]
• [Infectious risk headline: key positives/negatives, risk criteria status: Present / Absent / Unknown]
• [Organ quality headline]
• [Disposition: Accepted / Conditionally accepted / Declined] (If conditional, list conditions.)
• [Key pending data gating decision] (Only include if applicable.)

Donor & Organ Assessment

(Distinguish OPO-reported facts from program interpretation. Include timestamps for trends.)

Donor Overview

• [OPO] [Donor demographics: age, sex, height, weight, BMI]
• [OPO] [Relevant comorbidities and history]
• [OPO] [Hemodynamic status and vasopressor requirements with trends]
• [OPO] [Pertinent labs and trends]
• [Program] [Interpretation of donor stability and suitability]

ABO & Immunology

• [Donor ABO] → [Recipient ABO]: [Compatible / Intended incompatible]
• [Sensitization context: cPRA, unacceptable antigens, relevant history]
• [Virtual crossmatch interpretation: Negative / Positive / Indeterminate]
• [Physical crossmatch status: Pending / Resulted / Not required per protocol] (If resulted, state result and method.)

Organ-Specific Assessment (Include only the subsection matching the offered organ; remove others.)

Kidney

• [KDPI (%)}]
• [Creatinine trend: admission, peak, terminal with timestamps]
• [Biopsy findings: % glomerulosclerosis, IF/TA, vascular changes] (If available.)
• [Anatomic notes: multiple vessels, anomalies]
• [Program] [Bottom-line kidney quality statement]

Liver

• [LFT trends: AST/ALT, bilirubin, INR, lactate with timestamps]
• [Steatosis assessment: macrosteatosis %, method] (If available.)
• [Anatomic notes: size/weight, vascular/biliary variants]
• [Program] [Bottom-line liver quality statement including DCD WIT implications if applicable]

Heart

• [Echo findings: EF, wall motion, valve status with date]
• [Hemodynamic support: inotropes/pressors with doses]
• [Arrest/CPR history if any]
• [Coronary assessment if performed]
• [Program] [Bottom-line heart quality statement]

Lung

• [P/F ratio with timestamps]
• [Bronchoscopy findings and cultures] (If available.)
• [Ventilator settings, imaging highlights]
• [Smoking history and aspiration risk]
• [Program] [Bottom-line lung quality statement including DCD/WIT implications if applicable]

Pending Data at Time of Acceptance: [List pending labs, imaging, biopsy, crossmatch, or donor management updates] (State what is awaited and that it will be reviewed before transplant. If none, state "None.")

Infectious Risk & Consent

• HIV: [Ab/Ag result]; [NAT result]
• HBV: [HBsAg]; [anti-HBc]; [NAT]
• HCV: [Ab]; [NAT]
• Other: [CMV, EBV, syphilis, HTLV, other relevant tests as reported]
• Risk criteria for acute HIV/HBV/HCV transmission: [Present / Absent / Unknown] (If present, specify criteria.)
• Specific informed consent required: [Yes / No] (If Yes: [Who informed], [date/time], [by whom], [recipient decision].)
• OPTN risk disclosure completed: [Yes / No / N/A]
• Planned post-transplant monitoring: [Protocol, e.g., NAT testing schedule, prophylaxis]
• Pending infectious results: [List what is awaited] (If none, state "None.")

Decision & Rationale

Decision: [Accepted / Conditionally accepted / Declined]

• Conditions: [List explicit conditions if conditional acceptance, e.g., "Accept if crossmatch negative," "Accept if macrosteatosis ≤30%"] (Omit if unconditional acceptance or declined.)
• Decision-maker(s): [Attending/surgeon who made decision]
• Consulted parties: [HLA, ID, anesthesia, ICU as applicable]

Rationale:

• Benefit: [Urgency, expected outcomes, alternatives/waitlist considerations]
• Risks accepted: [Infectious, immunologic, quality/ischemia concerns]
• Mitigations: [Perioperative strategies, antimicrobial plans, immunologic strategies]

(If declined, state primary reason and brief explanation instead of benefit/risk/mitigation.)

Plan

• Logistics: [Anticipated cross-clamp date/time]; [Expected CIT/WIT]; [OR booking status]; [Transport/perfusion logistics]
• Pending prerequisites: [Results to review before proceeding with responsible owner]
• Operative considerations: [Special equipment, transfusion needs, vascular reconstruction, perfusion pump use]
• Immunosuppression: [Induction agent]; [Maintenance regimen]; [Modifications for risk factors]
• Post-op plan: [ICU disposition]; [Monitoring requirements]; [Early labs/imaging]; [Consults]
• Pathway: [Standard transplant pathway with any planned deviations noted]
• Follow-up: [What is awaited, who is responsible, next check-in time]

Compliance Statement: Formal pre-transplant verification and organ check-in will occur per institutional protocol. This note will be addended with updated donor data as received.

Addenda

(Use time-stamped addenda to document evolving donor data, decisions, and communications. Do not edit original content.)

• [Date/time]: [New information and source: OPO / Program]; [Impact on decision/plan]; [Author]

(If information is missing or pending, document as "Pending" or "Not available" rather than leaving blank. Tag facts with [OPO] or [Program] to distinguish source.)