CCTC Organ-Specific Transplant Knowledge 4

Question 1

A potential lung donor has a smoking history of 30 pack-years. Which additional evaluation is most critical before accepting the lungs?

Accepted Answer

Bronchoscopy to assess airway and secretions

Answer

Bronchoscopy allows direct visualization of the airways, assessment of secretions, purulence, or aspiration that would disqualify the lungs from transplantation.

Question 2

What is the significance of donor-specific antibodies (DSA) detected de novo after kidney transplantation?

Accepted Answer

They are a strong predictor of antibody-mediated rejection and graft loss

Answer

De novo DSA are antibodies the recipient develops against donor HLA antigens post-transplant and are strongly associated with antibody-mediated rejection and decreased long-term graft survival.

Question 3

In heart-lung transplantation, what is the most common indication in adult recipients?

Accepted Answer

Pulmonary arterial hypertension (PAH) with right heart failure

Answer

Pulmonary arterial hypertension with irreversible right ventricular failure is the most frequent indication for combined heart-lung transplantation in adults.

Question 4

Which bile duct reconstruction technique is preferred in liver transplantation when recipient bile duct is of adequate quality?

Accepted Answer

Duct-to-duct choledochocholedochostomy

Answer

Duct-to-duct (choledochocholedochostomy) biliary anastomosis is preferred as it preserves the sphincter of Oddi and allows ERCP access for post-transplant biliary complications.

Question 5

A deceased donor is found to have mild coronary artery disease on angiography. Under which circumstance might the heart still be considered for transplantation?

Accepted Answer

If recipient is Status 1A with no other available donors

Answer

In urgent circumstances such as a Status 1A recipient with no alternatives, a heart with mild CAD may be accepted after careful risk-benefit analysis by the transplant team.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Organ-Specific Transplant Knowledge 4