Donor 6230 - Medical Profile

This donor is a healthy carrier for a genetic disease.
Please see his Genetic Testing Summary and Acknowledgment of Genetic Risk for details

Personal Behavior History

Question	Response
Current alcohol use: If yes, oz./week and type of alcohol:	Rarely - a beer every 3 weeks or so
Tobacco use: Do you smoke? If yes, #/day and for how long:	No
If you did smoke but quit, when did you last smoke?	N/A
For how many years?	N/A
Do you sleep well?	Yes
Do you exercise on regular basis?	Yes
Is your diet well balanced? If no, explain:	Yes
Are you a vegetarian?	No
Any dietary restrictions? If yes, explain:	No

Sexual History

Question	Response
A partner whose sexual background you are unsure of in the past 12 months?	No

Donor Genetic History

Question	Response
Were you or any family members born with any birth defects? If yes, explain:	No
Have you been tested for Cystic Fibrosis? If yes, the result:	Yes - Non-carrier by gene sequencing
Karyotype? If yes, the result:	Yes - Normal karyotype
Spinal Muscular Atrophy (SMA)? If yes, the result:	Non Carrier - Standard donor screening
Tay Sachs? If yes, the result:	Non Carrier - by gene sequencing

Ancestry

Question	Response
Are you of Jewish ancestry? If yes, please note: Ashkenazi, Sephardi, or Other	No

If you are of Jewish ancestry, have you been tested as a carrier of any of the following diseases?

Question	Response
Tay Sachs: If yes, result(s):	Yes - Non-carrier by gene sequencing
Gaucher: If yes, result(s):	Yes - Non-carrier by gene sequencing
Canavan: If yes, result(s):	Yes - Non-carrier by gene sequencing
Fanconi Anemia Type C: If yes, result(s):	Yes - Non-carrier by gene sequencing
Niemann-Pick Type A: If yes, result(s):	Yes - Non-carrier by gene sequencing
Bloom Syndrome: If yes, result(s):	Yes - Non-carrier by gene sequencing
Familial Dysautonomia: If yes, result(s):	Yes - Non-carrier by gene sequencing
Mucolipidosis IV: If yes, result(s):	Yes - Non-carrier by gene sequencing
Maple Syrup Urine Disease 1B: If yes, result(s):	Yes - Non-carrier by gene sequencing
Usher Syndrome III & 1F: If yes, result(s):	Yes - Non-carrier by gene sequencing
Glycogen Storage Disease 1A: If yes, result(s):	Yes - Non-carrier by gene sequencing
ABCC8-Related Hyperinsulinism: If yes, result(s):	Yes - Non-carrier by gene sequencing
Lipoamide Dehydrogenase Deficiency: If yes, result(s):	Yes - Non-carrier by gene sequencing

Ancestry

Question	Response
Are you of African ancestry?	No
If yes, have you been tested as a carrier of sickle cell anemia?	Yes
If yes, result:	Non Carrier - by gene sequencing
Are you of Mediterranean, Greek or Italian ancestry?	No
If yes, have you been tested as a carrier of beta thalassemia?	Yes
If yes, result:	Non Carrier - by gene sequencing

Donor Medical History

Question	Response
List any operations: Age & reason:	Tonsils Removed - 12
Hospitalization other than surgery: Age & type of illness:	N/A
Have you ever had any broken bones? If yes, please give age and description:	Yes - Nose broken and reset, age 17, sports injury
Have you ever had any serious illnesses? If yes, please give age and description:	No
How many days in the past 12 months could you not work because of all illness (colds, flu, accidents, surgery, etc)? Please describe:	0
Are you presently under a physician's care for any reason? If yes, please describe:	No
List all drugs you have taken in past 12 months (prescription, nonprescription, herbal, and sports supplements, and recreational). Include drug, frequency and duration taken, and reason:	None
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:	None
Do you wear glasses or contact lenses? Are you near or far-sighted?	Yes - Near-sighted
Usual weight?	179
Recent weight loss or gain? # of lbs and reason:	No
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	No
Have you been tested for HIV (AIDS)? If yes, when:	Yes - Negative, ongoing donor screening
How many sexual partners do you currently have?	1
Have you ever had a tattoo? If yes, what year did you get the tattoo?	Yes - Multiple tattoos beginning in 2013
Have you ever had your ear(s) or body pierced? If yes, where and what year?	No

Family Medical History
See list of questions asked here

Your Mother

Question	Response
Current age or age at death	59
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father

Question	Response
Current age or age at death	60
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Brothers

Your Brother 1

Question	Response
Current age or age at death	40
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Brother 2

Question	Response
Current age or age at death	35
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Brother 3

Question	Response
Current age or age at death	30
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Father

Question	Response
Current age or age at death	84
Living / Dead	Dead
Cause of death and any treatment prior to death	Car accident

Health Problems

Healthy

Your Mother's Mother

Question	Response
Current age or age at death	81
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Sisters 1

Question	Response
Current age or age at death	49
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Brothers 1

Question	Response
Current age or age at death	62
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Mother's Brothers 2

Question	Response
Current age or age at death	45
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Father

Question	Response
Current age or age at death	93
Living / Dead	Dead
Cause of death and any treatment prior to death	Accident

Health Problems

Healthy

Your Father's Mother

Question	Response
Current age or age at death	90
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Sisters 1

Question	Response
Current age or age at death	63
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Sisters 2

Question	Response
Current age or age at death	58
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Sisters 3

Question	Response
Current age or age at death	56
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Sisters 4

Question	Response
Current age or age at death	54
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Brothers 1

Question	Response
Current age or age at death	68
Living / Dead	Dead
Cause of death and any treatment prior to death	Car accident

Health Problems

Healthy

Your Father's Brothers 2

Question	Response
Current age or age at death	59
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Health Problems

Healthy

Your Father's Brothers 3

Question	Response
Current age or age at death	52
Living / Dead	Dead
Cause of death and any treatment prior to death	Gun shot

Health Problems

Healthy

Donor Number: 6230

Personal Behavior History

Sexual History

Donor Genetic History

Donor Medical History

Family Medical HistorySee list of questions asked here

Family Medical History
See list of questions asked here