CCTC Evaluation and Preparation for Transplant 4

Question 1

Which scoring system is used to assess disease severity and waitlist priority for patients with primary biliary cholangitis awaiting liver transplant?

Accepted Answer

MELD or MELD-Na

Answer

MELD or MELD-Na is the standard UNOS allocation tool used for all chronic liver disease etiologies including primary biliary cholangitis.

Question 2

A renal transplant candidate has a BMI of 42. What is the primary concern at most transplant centers regarding listing this patient?

Accepted Answer

Increased risk of wound complications, delayed graft function, and reduced graft survival

Answer

Morbid obesity (BMI >40) is associated with higher surgical complication rates, wound dehiscence, delayed graft function, and worse long-term graft survival.

Question 3

During evaluation, a liver transplant candidate is found to have hepatopulmonary syndrome (HPS). How does this affect their transplant candidacy?

Accepted Answer

Severe HPS may qualify the patient for MELD exception points and HPS typically reverses post-transplant

Answer

HPS is a complication of portal hypertension that typically reverses after liver transplant; severe HPS (PaO2 <60 mmHg) can qualify patients for exception MELD points.

Question 4

What is the significance of elevated panel reactive antibody (PRA) levels greater than 80% in a kidney transplant candidate?

Accepted Answer

The patient is highly sensitized, limiting compatible donors and increasing rejection risk

Answer

PRA >80% indicates high sensitization, meaning fewer compatible donors are available and the risk of antibody-mediated rejection is significantly elevated.

Question 5

A candidate being evaluated for heart transplant has significant, unresolved pulmonary hypertension with transpulmonary gradient >15 mmHg. What is the most likely outcome of this finding?

Accepted Answer

Deferral pending optimization; severe fixed pulmonary hypertension contraindicates transplant due to right heart failure risk

Answer

Fixed pulmonary hypertension causes acute right ventricular failure in the donor heart; candidates must undergo vasodilator challenge to determine reversibility before listing.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Evaluation and Preparation for Transplant 4