Evaluation and Preparation for Transplant Flashcards
7 cards from real CCTC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Evaluation and Preparation for Transplant flashcards as text
A heart transplant candidate with a history of treated lymphoma is being evaluated. What minimum cancer-free interval is generally required before listing?
Answer: 2 years
Most transplant centers require at least 2 to 5 years of cancer-free interval depending on tumor type and stage, balancing recurrence risk against transplant urgency.
Which hepatic lesion scoring system is used to prioritize liver transplant candidates with hepatocellular carcinoma (HCC) within UNOS criteria?
Answer: Milan Criteria with MELD exception points
Candidates with HCC within Milan Criteria (1 lesion ≤5 cm or up to 3 lesions ≤3 cm each, no vascular invasion) receive MELD exception points to improve their allocation priority.
When evaluating a patient for kidney-pancreas transplant, which condition in the recipient must be present to justify simultaneous pancreas transplantation?
Answer: Type 1 diabetes with end-stage renal disease
Simultaneous pancreas-kidney (SPK) transplant is primarily indicated in Type 1 diabetics with ESRD, as both organs address insulin deficiency and its renal complications.
During psychosocial evaluation, which factor is considered an ABSOLUTE contraindication to transplant listing at most centers?
Answer: Active alcohol or substance abuse without documented sobriety
Active substance abuse without documented sobriety and treatment is an absolute contraindication because it predicts non-adherence and graft failure.
A transplant coordinator reviews crossmatch results and notes a positive T-cell crossmatch. What does this finding indicate?
Answer: Presence of donor-specific antibodies against HLA class I antigens; transplant is contraindicated
A positive T-cell crossmatch indicates DSA against class I HLA on donor T-cells, predicting hyperacute or accelerated rejection and is a contraindication to transplant.
What is the role of a financial coordinator in the pretransplant evaluation process?
Answer: Verifying insurance coverage and identifying funding gaps for transplant and post-transplant care
Financial coordinators ensure the patient has adequate coverage for surgery, hospitalization, and lifelong immunosuppression, as financial non-adherence can lead to graft loss.
Which pre-transplant vaccination is especially critical to administer BEFORE transplant in all candidates, given its live-attenuated nature?
Answer: Varicella zoster (Zostavax)
Live-attenuated vaccines like varicella/zoster must be given before transplant because post-transplant immunosuppression precludes safe administration of live vaccines.