CCTC Patient and Family Education 3 — Questions and Answers
Question 1: A liver transplant patient wants to resume moderate alcohol consumption six months post-transplant. How should the coordinator respond?
- Moderate alcohol is acceptable after one year post-transplant
- Alcohol is permanently contraindicated for patients transplanted due to alcohol-related liver disease (Correct answer)
- Beer is acceptable but spirits are not
- Alcohol use is fine as long as liver enzymes remain normal
Correct answer: Alcohol is permanently contraindicated for patients transplanted due to alcohol-related liver disease
Patients transplanted for alcohol-related liver disease are required to maintain lifelong sobriety as alcohol use can cause recurrent disease and graft loss.
Question 2: A female kidney transplant recipient asks when it is safe to become pregnant. What guidance should the CCTC provide?
- Pregnancy should be avoided permanently after transplantation
- Wait at least one to two years post-transplant with stable graft function and adjusted immunosuppression (Correct answer)
- Pregnancy is safe immediately after hospital discharge
- Contraception is unnecessary because immunosuppression reduces fertility
Correct answer: Wait at least one to two years post-transplant with stable graft function and adjusted immunosuppression
Guidelines recommend waiting at least one to two years post-transplant until graft function is stable and teratogenic agents are minimized before attempting pregnancy.
Question 3: A patient discharged after a kidney transplant does not understand why they need frequent laboratory draws. What is the best rationale to provide?
- Labs are required only for research purposes
- Frequent monitoring detects rejection, drug toxicity, and infection early when intervention is most effective (Correct answer)
- Lab work is only necessary if symptoms develop
- Labs confirm that the immune system is fully suppressed
Correct answer: Frequent monitoring detects rejection, drug toxicity, and infection early when intervention is most effective
Routine laboratory surveillance enables early detection of rejection, immunosuppressant toxicity, and opportunistic infections before clinical deterioration.
Question 4: Which dietary restriction is specifically important to teach a transplant patient taking tacrolimus or cyclosporine?
- Avoid all dairy products
- Avoid grapefruit and grapefruit juice (Correct answer)
- Eliminate all sodium from the diet
- Restrict protein to less than 20 grams per day
Correct answer: Avoid grapefruit and grapefruit juice
Grapefruit inhibits CYP3A4 metabolism, causing unpredictable increases in calcineurin inhibitor blood levels and toxicity risk.
Question 5: A patient's teenage child asks the coordinator if they can donate blood to help their parent after the transplant. What is the most accurate response?
- Family blood donations are always ideal for transplant recipients
- Directed family donations carry a risk of sensitization and are generally avoided in potential future recipients (Correct answer)
- Children under 18 are prohibited from all donation activities
- Blood transfusions are unnecessary after transplantation
Correct answer: Directed family donations carry a risk of sensitization and are generally avoided in potential future recipients
Directed family donations can sensitize the recipient to HLA antigens shared with potential future living donors, complicating future transplants.
Question 6: A liver transplant patient reports taking St. John's Wort for depression. What is the most important concern to address?
- St. John's Wort causes hepatotoxicity in transplant patients
- St. John's Wort induces CYP3A4 and can significantly decrease immunosuppressant levels, risking rejection (Correct answer)
- St. John's Wort is only problematic when combined with steroids
- St. John's Wort is acceptable if liver enzymes remain stable
Correct answer: St. John's Wort induces CYP3A4 and can significantly decrease immunosuppressant levels, risking rejection
St. John's Wort is a potent CYP3A4 inducer that can dramatically reduce calcineurin inhibitor levels, precipitating acute rejection.
Question 7: When educating a pancreas transplant recipient, the coordinator should instruct the patient to report which symptom as a potential sign of rejection?
- Gradual weight loss over several months
- Rising blood glucose levels in a previously well-controlled patient (Correct answer)
- Mild seasonal allergy symptoms
- Temporary blurred vision after reading
Correct answer: Rising blood glucose levels in a previously well-controlled patient
A return of hyperglycemia in a pancreas transplant recipient may indicate graft rejection or failure, requiring urgent evaluation.
CCTC Patient and Family Education 3
A liver transplant patient wants to resume moderate alcohol consumption six months post-transplant.
How should the coordinator respond?