PROTECT-CHILD Pediatric Transplant Data Implementation Guide, published by Protect Child. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/protect-child/ and changes regularly. See the Directory of published versions

Clinical Event

Primary profile: ClinicalEvent (Condition)
Flag observations: ClinicalEventFlagObservation (Observation), one per recorded non-diagnosis flag (concomitant_medications, treatment_adherence), valueBoolean true or false, focus = Reference(ClinicalEvent)

Concept map: ClinicalEventLmToFhir

Cardinality key — M = Mandatory (1..1) · R = Recommended (0..1) · O = Optional (0..1)

Clinical events are post-transplant complications, rejection episodes, graft failure, retransplantation and mortality. ClinicalEventTypeCS / ClinicalEventTypeVS hold the data model's 26 event types plus three diagnosis flags (AKI after liver transplant, histological CNI toxicity, hypoxic-ischemic event); dgf reuses delayed graft function.

One episode is one Condition. The data model's START and END clinical_event rows fold into one Condition:

• START row → Condition.onsetDateTime, clinicalStatus = #active, encounter = that visit
• END row → Condition.abatementDateTime, clinicalStatus = #resolved, and the visit in extension[endVisit]
• both clinical_event_ids are kept in Condition.identifier

Organ scope. DMv1.2 marks every clinical_event column as Both, and this guide follows it. Six columns name one organ: specify_kidney_rejection_episode, previous_urological_intervention, kidney_biopsy and dgf (kidney), episodes_aki_after_ltx and hypoxic_ischemic_event_pltx (liver). We should consider restricting each to that organ's actor.

A visit may carry several events. The data model declares visit → clinical_event as One-to-One.

Linked Procedures

Sub-events with a coded type and date are ClinicalEventProcedure (Procedure) resources, linked to the parent ClinicalEvent via Procedure.reasonReference.