CCTC CCTC - Certified Clinical Transplant Coordinator Infection Prevention and Management Questions and Answers 5

Question 1

A transplant coordinator reviews CMV prophylaxis protocols. Which transplant recipient category is considered 'high risk' and typically requires 6 months of antiviral prophylaxis rather than 3 months?

Accepted Answer

CMV D+/R+ (both seropositive) lung transplant

Answer

Lung transplant recipients who are D+/R+ are considered high risk due to the graft being directly exposed to inhaled pathogens and the intensity of immunosuppression required, warranting extended 6-month prophylaxis.

Question 2

Which of the following best describes the mechanism by which calcineurin inhibitors increase susceptibility to fungal infections in transplant recipients?

Accepted Answer

They suppress T-lymphocyte activation and IL-2 production, impairing cell-mediated immunity

Answer

Calcineurin inhibitors block T-cell activation by inhibiting calcineurin-mediated IL-2 transcription, impairing cell-mediated immunity, which is the primary defense against fungal pathogens.

Question 3

A transplant recipient returns from international travel with fever, night sweats, and weight loss. Chest imaging shows upper lobe cavitary lesions. Which opportunistic infection must be immediately excluded?

Accepted Answer

Mycobacterium tuberculosis reactivation

Answer

Mycobacterium tuberculosis must be urgently excluded in any immunocompromised patient with upper lobe cavitary lesions, fever, and constitutional symptoms, as reactivation risk is significantly elevated post-transplant.

Question 4

A transplant coordinator notes that a recipient's anti-HBs titer has dropped below 10 mIU/mL after receiving a liver from an HBsAg-negative, HBcAb-positive donor. What is the most appropriate long-term management strategy?

Accepted Answer

Start indefinite entecavir prophylaxis and monitor HBV DNA levels

Answer

Recipients of grafts from HBcAb-positive donors are at risk for de novo hepatitis B infection and require indefinite antiviral prophylaxis with a potent agent like entecavir along with regular HBV DNA monitoring.

Question 5

Which of the following is the most appropriate screening test to evaluate a potential transplant recipient for latent Mycobacterium tuberculosis infection before transplantation?

Accepted Answer

Interferon-gamma release assay (IGRA) or tuberculin skin test (TST)

Answer

IGRA (e.g., QuantiFERON-TB Gold) or TST is recommended for pre-transplant latent TB screening; IGRA is preferred as it is unaffected by prior BCG vaccination and requires a single blood draw.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC CCTC - Certified Clinical Transplant Coordinator Infection Prevention and Management Questions and Answers 5