Donor 5164 - Summary Profile

Physical

Medical

Question	Response
Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected:	No
Any dietary restrictions? If yes, explain:	No
Do you wear glasses or contact lenses? Are you near or far-sighted?	Yes - Near-sighted
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Slight peanut butter allergy: Causes itchy tongue
CMV IgG Antibody	Positive
CMV IgM Antibody	Negative
Note any comments regarding above items:	N/A

Family Medical History
See list of questions asked here

Your Mother

Question	Response	Comment/Age Affected
Current age or age at death	69
Health Problem	Healthy
Living / Dead	Living

Your Father

Question	Response	Comment/Age Affected
Current age or age at death	69
Health Problem	Healthy
Living / Dead	Living

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	45
Health Problem	Healthy
Living / Dead	Living

Your Brother 2

Question	Response	Comment/Age Affected
Current age or age at death	0	(Donor's fraternal twin, age not given to protect donor's anonymity)
Health Problem	Healthy
Living / Dead	Living

Daughters

Your Daughter 1

Question	Response	Comment/Age Affected
Current age or age at death	8
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	78
Health Problem	Heart attack, fatal, no treatment	78
Health Problem	Cause of death: Heart attack	78
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	89
Health Problem	Pneumonia, treated with antibiotics	88
	Heart failure	89
	Cause of death: Heart failure	89
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	72
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	66
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 3

Question	Response	Comment/Age Affected
Current age or age at death	64
Health Problem	Colon cancer, treated with surgery	60
Living / Dead	Living

Your Mother's Sisters 4

Question	Response	Comment/Age Affected
Current age or age at death	59
Health Problem	Overweight since her teens, unknown if she has been diagnosed with obesity
Health Problem	Diabetes, treated with insulin therapy	45
Living / Dead	Living

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	71
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	61
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 3

Question	Response	Comment/Age Affected
Current age or age at death	58
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	90
Health Problem	Stroke, treated in hospital	90
Health Problem	Cause of death: Stroke	90
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	89
Health Problem	Foot amputation, reason unknown, but possibly due to a blood clot	89
	Foot amputation complication, resulting in infection	89
	Cause of death: Infection	89
Living / Dead	Dead

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	66
Health Problem	Healthy
Living / Dead	Living

Height: 5'9" (175 cm)	Weight: 188 lb (85 kg)	Eye Color: Blue	Hair: Brown/ Wavy	Skin Tone: Light	Ancestry: Caucasian
	Blood Type: B+	Ethnic Background: Italian/Belgian-German
	Education: MBA		Occupation: Analyst
Interests:	Art

Faith	Christian
Denomination	Catholic

Update Available	Yes
Updates - Personal	No change to profile: September 2020. Update received March 2023: Occupation has changed to Finance Manager.
Updates - Medical	No change to profile: September 2020, March 2023.
Updates - Family Medical History	No change to profile: September 2020, March 2023.

Donor Number: 5164

Physical

Medical

Family Medical History
See list of questions asked here

Religion:

Updates to Profile

Donor Number: 5164

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here