WMDA form: CB30

Name CB30
Description Cord Blood Unit Shipment Request

Dictionary Fields

Name of field on form Dictionary label (description) EMDIS fields (matching dictionary field) WMDA XML fields (matching dictionary field)
Hemoglobinopathy screen
(Hemoglobinopathy screening status)
CB_HEMO_STATUS
HEMO_STATUS
Preferred date (collection/shipment) 2
(Second preferred date for collection / CBU shipment per TC)
ALTER_DATE1
Preferred date (collection/shipment) 3
(Third preferred date for collection / CBU shipment per TC)
ALTER_DATE2
Total colony forming units (CFU)
(Total CFU post processing count (post processing and pre-cryopreservation). GM method)
CB_CFU_FRZN
CFU_FRZN
Total number of days of conditioning regimen
(The number of condititioning days the patient will have prior to transplantation)
COND_DAYS
Unit DNA sample availability
(Unit DNA sample that may be available for shipment)
CB_DNA_SMPL
DNA_AVA
DNA_SMPL
Unit verification typing date
(Need to define what constitutes VT ( current FACT standards?) Date verification typing was completed)
CB_CT_COMPLETE_DATE
CT_COMPLETE_DATE
Cord Blood Unit Identification
(CBU identification)
CB_ID
ID
Preferred date (collection/shipment) 1
(First preferred date for collection / CBU shipment per TC)
PROP_DATE
Request date
(Date of request)
REQ_DATE
Blood Group (ABO)
(Blood Group (ABO))
CB_ABO
D_ABO
D_ABO (IDM_RES)
P_ABO
ABO
Blood Group (Rhesus)
(Blood Group (Rhesus))
RHESUS
First line of address
(The first line of an address, generally for an organisation, can be any format)
ADDR_1
Second line of address
(The second line of an address, generally for an organisation, can be any format)
ADDR_2
Third line address
(The third line of an address, generally for an organisation, can be any format)
ADDR_3
City Address
(The city of an address, generally for an organisation, can be any format)
CITY
Country
(The country of an address, generally for an organisation, can be any format)
COUNTRY
Email
(email address, generally for an organisation, can be any format)
EMAIL
Fax Number
(Fax number, usually of an organisation)
FAX
Receiving institution
(Institution receiving a product ( sample, HPC))
INST_MARR_SENT
INST_SMP_SENT
Invoice institution
(institution responsible for paying, usually requesting TC or registry)
INST_PAY
Postal Code
(Postal code (or zip code) of an address)
ZIP
Diagnosis details
(Additional explanatory text describing diagnosis of the patient)
P_DIAG_TEXT
Institution
(Identification of an institution, usually refers to a receiving or sending regsitry.)
INST_ID
Contact phone number
(The listed phone number to contact at an organisation usually a registry or transplant centre)
PHONE
Weight
(Weight measured in kilograms)
D_WEIGHT
P_WEIGHT
WEIGHT
First name
(Given name of an individual)
P_FNAME
Patient Identification
(Patient identification assigned by patient registry)
P_ID
RSV_PAT
Last name
(Surname of an individual)
P_LNAME