CCTC Organ-Specific Transplant Knowledge 3

Question 1

A liver transplant recipient on post-op day 3 develops a rise in AST/ALT to 10x normal with fever. What is the most likely diagnosis?

Accepted Answer

Hepatic artery thrombosis

Answer

Hepatic artery thrombosis typically presents in the early post-transplant period with dramatic elevation of liver enzymes and is confirmed by Doppler ultrasound.

Question 2

Which immunosuppression medication requires therapeutic drug monitoring via trough levels and is nephrotoxic in kidney transplant recipients?

Accepted Answer

Tacrolimus

Answer

Tacrolimus is a calcineurin inhibitor requiring trough level monitoring due to its narrow therapeutic window and significant nephrotoxicity.

Question 3

In pediatric heart transplantation, which factor most strongly influences waitlist mortality compared to adults?

Accepted Answer

Limited donor pool and size matching requirements

Answer

Pediatric patients face higher waitlist mortality due to the limited pool of size-matched donors and the stringency of weight-appropriate organ matching.

Question 4

What is the role of the Lung Allocation Score (LAS) in lung transplantation?

Accepted Answer

Prioritize candidates based on urgency and expected post-transplant survival

Answer

The LAS was implemented to replace wait-time-based allocation and instead prioritize candidates who have the greatest medical urgency and expected benefit from transplantation.

Question 5

A kidney transplant recipient has a declining eGFR at 6 months post-transplant. Biopsy shows interstitial fibrosis and tubular atrophy (IFTA). What does this typically represent?

Accepted Answer

Chronic allograft nephropathy

Answer

IFTA on biopsy at 6 months post-transplant with declining eGFR is the hallmark of chronic allograft nephropathy, a multifactorial process leading to progressive graft loss.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Organ-Specific Transplant Knowledge 3