CCTC Organ Procurement and Preservation 1 — Questions and Answers
Question 1: What is the primary purpose of hypothermic preservation in organ procurement?
- To sterilize the organ before transplantation
- To slow cellular metabolism and extend organ viability (Correct answer)
- To increase oxygen delivery to tissues
- To enhance immune tolerance in the recipient
Correct answer: To slow cellular metabolism and extend organ viability
Hypothermic preservation slows metabolic activity, reducing oxygen consumption and extending the time organs can remain viable before transplantation.
Question 2: Which preservation solution is most commonly used for kidney procurement in the United States?
- Normal saline
- Lactated Ringer's solution
- University of Wisconsin (UW) solution (Correct answer)
- 5% Dextrose in water
Correct answer: University of Wisconsin (UW) solution
UW solution is the gold standard for kidney preservation because it prevents cellular swelling, oxidative injury, and ATP depletion during cold storage.
Question 3: What does DCD stand for in the context of organ donation?
- Donation after Cardiac Death (Correct answer)
- Direct Cell Donation
- Deceased Clinical Donor
- Delayed Cold Donation
Correct answer: Donation after Cardiac Death
DCD (Donation after Cardiac Death) refers to organ procurement following irreversible cessation of circulatory and respiratory functions.
Question 4: Which organ has the shortest acceptable total ischemia time due to its extreme sensitivity?
- Kidney
- Liver
- Heart (Correct answer)
- Intestine
Correct answer: Heart
The heart is extremely sensitive to ischemia and has the shortest acceptable cold ischemia time, generally limited to 4–6 hours from cross-clamp to reperfusion.
Question 5: What is the primary role of an Organ Procurement Organization (OPO) in the transplantation process?
- Performing transplant surgeries at recipient centers
- Providing lifelong post-transplant follow-up care
- Coordinating organ recovery, preservation, and allocation (Correct answer)
- Managing recipient immunosuppression protocols
Correct answer: Coordinating organ recovery, preservation, and allocation
OPOs identify potential donors, coordinate consent, manage organ recovery and preservation, and facilitate allocation through UNOS/OPTN.
Question 6: Cold ischemia time (CIT) is measured from which point to which point?
- Brain death declaration to transplant surgery start
- Aortic cross-clamp and cold flush in the donor to reperfusion in the recipient (Correct answer)
- Procurement surgery incision to organ arrival at the transplant center
- Donor hospital admission to recipient anesthesia induction
Correct answer: Aortic cross-clamp and cold flush in the donor to reperfusion in the recipient
Cold ischemia time is defined from the moment of aortic cross-clamp and cold perfusion in the donor to the restoration of blood flow (reperfusion) in the recipient.
Question 7: Which of the following is required for a legal declaration of brain death in a potential organ donor?
- Presence of pupillary response to light
- A reversible cause of coma
- Irreversible cessation of all brain functions including the brainstem (Correct answer)
- Preservation of spinal cord reflexes
Correct answer: Irreversible cessation of all brain functions including the brainstem
Brain death requires documented irreversible loss of all brain functions, including brainstem activity, confirmed by clinical examination and apnea testing.
CCTC Organ Procurement and Preservation 1
What is the primary purpose of hypothermic preservation in organ procurement?