CCTC Living Donor Assessment Process 4 — Questions and Answers
Question 1: A potential living kidney donor has a BMI of 36. According to most transplant center guidelines, what is the recommended approach?
- Automatic exclusion as all centers require BMI under 30
- Weight loss counseling with reassessment after achieving a lower BMI (Correct answer)
- Proceed with donation as BMI is not a significant risk factor
- Refer for bariatric surgery prior to evaluation
Correct answer: Weight loss counseling with reassessment after achieving a lower BMI
Obesity increases surgical and long-term renal risk; most centers counsel weight loss and reassess rather than applying automatic exclusion.
Question 2: Which component of the donor crossmatch specifically tests for preformed donor-specific antibodies in the recipient's serum?
- ABO typing
- Flow cytometry crossmatch (Correct answer)
- HLA tissue typing
- Complete blood count
Correct answer: Flow cytometry crossmatch
Flow cytometry crossmatch detects low-level preformed donor-specific antibodies in recipient serum that could cause rejection.
Question 3: A living donor candidate is a 58-year-old with a family history of type 2 diabetes. Which additional test is most critical in her evaluation?
- Fasting lipid panel
- Oral glucose tolerance test (OGTT) (Correct answer)
- Hemoglobin A1c alone
- Fasting insulin level
Correct answer: Oral glucose tolerance test (OGTT)
An OGTT provides the most comprehensive assessment of glucose metabolism and can detect impaired glucose tolerance not captured by HbA1c alone.
Question 4: Which right kidney anatomical variant most commonly prompts preference for left kidney donation in living donor nephrectomy?
- Right kidney is larger than left
- Right renal vein is shorter than the left (Correct answer)
- Right kidney has a horseshoe variant
- Right kidney has multiple simple cysts
Correct answer: Right renal vein is shorter than the left
The shorter right renal vein makes anastomosis technically more challenging, so surgeons typically prefer to recover the left kidney with its longer vein.
Question 5: When obtaining informed consent from a living donor, which element is considered most essential by both ethical and OPTN standards?
- Signature witnessed by the recipient's transplant surgeon
- Disclosure of all known and quantifiable risks including long-term renal outcomes (Correct answer)
- Agreement to donate regardless of any last-minute change of mind
- Confirmation that no alternative deceased donor is available
Correct answer: Disclosure of all known and quantifiable risks including long-term renal outcomes
Full disclosure of risks, including long-term outcomes, is the cornerstone of valid informed consent for living donation.
Question 6: A potential living donor who is also a gestational carrier (surrogate) for the recipient's family requests expedited evaluation. What concern should the coordinator prioritize?
- Scheduling conflicts due to IVF appointments
- Coercion risk given the financial and relationship dynamics with the recipient's family (Correct answer)
- Risk of immunologic sensitization from the surrogate pregnancy
- Whether the recipient's insurance covers both procedures
Correct answer: Coercion risk given the financial and relationship dynamics with the recipient's family
Surrogacy arrangements create complex financial and emotional ties that elevate coercion risk and require careful psychosocial scrutiny.
Question 7: Which OPTN-required document must a living donor sign to confirm they understand they may withdraw consent at any time without penalty?
- Living Donor Medical History Form
- Living Donor Informed Consent Acknowledgment (Correct answer)
- Donor Attestation Form
- HIPAA Release Authorization
Correct answer: Living Donor Informed Consent Acknowledgment
The Living Donor Informed Consent Acknowledgment documents the donor's understanding of voluntary participation, including the right to withdraw.
CCTC Living Donor Assessment Process 4
A potential living kidney donor has a BMI of 36.
According to most transplant center guidelines, what is the recommended approach?