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ID# Pediatric Heart Transplant Study FORM 1105: ReTransplantationSequential Patient Number Complete for all patients retransplanted at your institution that were entered into the PUTS. Please use

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What is form 1105 re-transplantation?

Form 1105 re-transplantation is a document used to apply for re-transplantation of an organ.

Who is required to file form 1105 re-transplantation?

Patients who are seeking re-transplantation of an organ are required to file form 1105 re-transplantation.

How to fill out form 1105 re-transplantation?

Form 1105 re-transplantation must be filled out by providing information about the patient's medical history, reasons for re-transplantation, and other relevant details.

What is the purpose of form 1105 re-transplantation?

The purpose of form 1105 re-transplantation is to formally request re-transplantation of an organ.

What information must be reported on form 1105 re-transplantation?

Form 1105 re-transplantation must include patient's personal information, medical history, current health status, reasons for re-transplantation, and any supporting documents.

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