CCTC Deceased Donor Evaluation and Brain Death Determination

Question 1

Which of the following best defines Donation after Circulatory Death (DCD)?

Accepted Answer

Organ recovery following withdrawal of life-sustaining treatment and confirmation of circulatory arrest

Answer

Organ recovery from a donor who meets standard neurological brain death criteria

Answer

Organ recovery from a living donor who undergoes planned cardiac arrest under anesthesia

Answer

Organ recovery performed concurrently with active cardiopulmonary resuscitation efforts

Question 2

Most U.S. hospital protocols for declaring brain death require which of the following?

Accepted Answer

Two independent physicians, with the transplant team explicitly excluded from making the determination

Answer

One attending physician and written family consent

Answer

Three physicians including the transplant surgeon to confirm organ suitability

Answer

A transplant coordinator and a neurologist acting together

Question 3

The PHS Guideline for identifying 'increased infectious disease risk' donors primarily addresses transmission risk for which pathogens?

Accepted Answer

HIV, HCV, and HBV

Answer

CMV, EBV, and Toxoplasma

Answer

MRSA, VRE, and Candida

Answer

West Nile Virus, Rabies, and Prion disease

Question 4

A potential deceased donor has a serum creatinine of 3.8 mg/dL on ICU admission secondary to hypotension-induced acute kidney injury. After aggressive fluid resuscitation and hemodynamic optimization, creatinine falls to 0.9 mg/dL. Which statement most accurately describes kidney transplant suitability?

Accepted Answer

Kidneys may be suitable; acute kidney injury with functional recovery is not an absolute contraindication

Answer

Kidneys are absolutely excluded due to the peak creatinine exceeding 2.0 mg/dL

Answer

Kidneys must be automatically classified as Expanded Criteria Donor (ECD) regardless of recovery

Answer

A pre-procurement biopsy showing >20% global sclerosis is required before placement can be considered

Question 5

The hormonal resuscitation protocol commonly applied to brain-dead deceased donors (the 'TVCI' or similar protocol) addresses which physiological consequence of brain death?

Accepted Answer

Hypothalamic-pituitary axis dysfunction causing multi-hormonal deficiency

Answer

Cerebral edema causing elevated intracranial pressure

Answer

Catecholamine storm causing refractory hypertension

Answer

Hyperglycemia from corticosteroid pretreatment prior to brain death

Question 6

A potential donor has a positive nucleic acid test (NAT) for HCV. The intended kidney recipient has been waitlisted for 6 years and faces continued deteriorating health on dialysis. After thorough discussion, the recipient provides informed consent to accept the organ. Which statement is correct?

Accepted Answer

With recipient informed consent and the availability of curative direct-acting antiviral (DAA) therapy, transplanting an HCV-NAT-positive organ into an HCV-negative recipient is an accepted and policy-compliant practice

Answer

Acceptance is prohibited; HCV-positive organs may only be transplanted into HCV-positive recipients

Answer

The transplant must be reported to UNOS as a mandatory protocol violation

Answer

Only centers with a specific HCV waiver from CMS may perform such transplants