CCTC - Certified Clinical Transplant Coordinator Immediate Postoperative Care Questions and Answers

Question 1

A kidney transplant recipient, 6 hours postoperative, experiences a sudden decrease in urine output from 150 mL/hr to less than 20 mL/hr.
The patient's blood pressure and central venous pressure are stable.
What is the MOST appropriate initial action for the transplant coordinator to anticipate?

Accepted Answer

Obtaining an urgent renal ultrasound with Doppler.

Answer

Administration of an intravenous fluid bolus.

Answer

Sending a urine sample for culture and sensitivity.

Answer

Preparing for emergent hemodialysis.

Question 2

A heart transplant recipient is receiving basiliximab as part of their induction immunosuppression. The coordinator knows this medication works by which of the following mechanisms?

Accepted Answer

Binding to the IL-2 receptor on activated T-cells.

Answer

Depleting circulating T-lymphocytes.

Answer

Inhibiting the production of Interleukin-2 (IL-2).

Answer

Blocking the mTOR signaling pathway in lymphocytes.

Question 3

A patient is 48 hours post-liver transplant. The transplant coordinator is reviewing labs and notes a progressively rising INR to 3.0, AST >3000 IU/L, metabolic acidosis, and minimal bile output. These findings are most indicative of which immediate postoperative complication?

Accepted Answer

Primary Graft Non-function (PNF)

Answer

Biliary stricture

Answer

Acute cellular rejection

Answer

Hepatic artery stenosis

Question 4

A patient 12 hours post-bilateral lung transplant develops progressive hypoxemia with increasing oxygen requirements and diffuse infiltrates on chest x-ray. Hemodynamics are stable and there is no evidence of fluid overload. Which complication is the most likely cause?

Accepted Answer

Primary Graft Dysfunction (PGD)

Answer

Hospital-acquired pneumonia

Answer

Acute cellular rejection

Answer

Post-transplant lymphoproliferative disorder (PTLD)

Question 5

A kidney transplant recipient is started on a standard postoperative regimen of high-dose corticosteroids and tacrolimus. The transplant coordinator should be vigilant in monitoring the patient for which common metabolic side effect?

Accepted Answer

Hyperglycemia

Answer

Hypokalemia

Answer

Hyponatremia

Answer

Hypoglycemia

Question 6

A transplant coordinator is preparing discharge education for a liver recipient. Which medication is routinely prescribed for prophylaxis against Pneumocystis jirovecii pneumonia (PJP) in the initial postoperative period?

Accepted Answer

Trimethoprim-sulfamethoxazole

Answer

Valganciclovir

Answer

Nystatin suspension

Answer

Fluconazole

A kidney transplant recipient, 6 hours postoperative, experiences a sudden decrease in urine output from 150 mL/hr to less than 20 mL/hr.The patient's blood pressure and central venous pressure are stable.What is the MOST appropriate initial action for the transplant coordinator to anticipate?

A kidney transplant recipient, 6 hours postoperative, experiences a sudden decrease in urine output from 150 mL/hr to less than 20 mL/hr.
The patient's blood pressure and central venous pressure are stable.
What is the MOST appropriate initial action for the transplant coordinator to anticipate?