Long-Term Recipient Management 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 Long-Term Recipient Management flashcards as text
A kidney transplant recipient at 3 years post-transplant has a serum creatinine that has slowly risen from 1.2 to 2.1 mg/dL over 6 months. The most likely diagnosis is:
Answer: Chronic allograft nephropathy
Slowly progressive decline in renal function years after transplant is the hallmark of chronic allograft nephropathy (interstitial fibrosis/tubular atrophy).
Which vaccine is CONTRAINDICATED in solid organ transplant recipients on immunosuppression?
Answer: Live attenuated varicella zoster vaccine
Live attenuated vaccines are contraindicated in immunocompromised transplant recipients due to risk of vaccine-strain infection.
A liver transplant recipient develops hypertension, hyperlipidemia, and new-onset diabetes 2 years post-transplant. These findings together are best described as:
Answer: Post-transplant metabolic syndrome
The cluster of hypertension, dyslipidemia, and new-onset diabetes after transplant (NODAT) defines post-transplant metabolic syndrome, largely driven by immunosuppression.
Which malignancy has the highest increased incidence in long-term transplant recipients compared to the general population?
Answer: Non-melanoma skin cancer
Non-melanoma skin cancers (squamous and basal cell) are dramatically more common in transplant recipients, with squamous cell carcinoma occurring up to 100 times more often.
A transplant coordinator is counseling a 5-year post-kidney-transplant recipient about sun protection. The PRIMARY reason is:
Answer: Immunosuppression increases skin cancer risk
Chronic immunosuppression impairs immune surveillance against skin carcinogenesis, making sun protection critical for long-term recipients.
A heart transplant recipient at 7 years post-transplant is found to have diffuse concentric luminal narrowing on coronary angiography. This is most consistent with:
Answer: Cardiac allograft vasculopathy
Cardiac allograft vasculopathy (CAV) causes diffuse, concentric intimal hyperplasia affecting the entire coronary tree and is distinct from native atherosclerosis.
When monitoring tacrolimus levels in a stable long-term transplant recipient, the coordinator should know that target trough levels are typically:
Answer: Lower than early post-transplant targets
Immunosuppression is typically minimized over time; tacrolimus trough targets decrease from early post-transplant levels (10-15 ng/mL) to lower maintenance levels (5-8 ng/mL).