Q99-112: Maximum Severity

The following section is intended to capture the maximum severity of VOD/SOS during the current reporting period. If this form is being completed for the six month follow-up report the maximum values obtained during the current reporting period. Do not report values from the 100 day reporting period on the 6-month follow-up form.

Question 99-100: Maximum recipient weight

Indicate whether the recipient’s maximum weight during the reporting period is known. If the maximum weight is known, report the weight in question 100. If the recipient was diagnosed with VOD/SOS during the current reporting period, report the maximum value between diagnosis and the end of the reporting period. If the maximum weight is not known, continue with question 101.

Question 101-103: Maximum total serum bilirubin

Indicate whether the recipient’s maximum total serum bilirubin during the reporting period is known. If the maximum total bilirubin is known, report the value in question 102 and indicate the date the sample was collected in question 103. If the recipient was diagnosed with VOD/SOS during the current reporting period, report the maximum value between diagnosis and the end of the reporting period. If the maximum total bilirubin is not known, continue with question 104.

Question 104-106: Maximum serum creatinine

Indicate whether the recipient’s maximum serum creatinine during the reporting period is known. If the maximum serum creatinine is known, report the value in question 105 and indicate the date the sample was collected in question 106. If the recipient was diagnosed with VOD/SOS during the current reporting period, report the maximum value between diagnosis and the end of the reporting period. If the maximum serum creatinine is not known, continue with question 107.

Question 107-110: Was the recipient placed on dialysis?

Indicate if the recipient underwent renal replacement therapy (e.g., dialysis or CVVH/ultrafiltration), even once, during the reporting period. If the recipient was diagnosed with VOD/SOS during the current reporting period, only report “yes” if the recipient underwent dialysis following the diagnosis of VOD/SOS. If dialysis was performed, report the first treatment date in question 108 and also indicate whether the recipient is still undergoing dialysis treatments at the time of the date of contact.

If the recipient stopped dialysis during the reporting period, report the date of the last run in question 110.

Question 111-112: Specify the maximum oxygen requirements

Report the maximum amount of oxygen support required during the reporting period. If the recipient was diagnosed with VOD/SOS during the current reporting period, only report the maximum requirement since the date of diagnosis.

If reporting “other oxygen requirement,” specify the type of oxygen support administered in question 112.

Section Updates:

Question Number	Date of Change	Add/Remove/Modify	Description	Reasoning (If applicable)
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