CCTC Patient and Family Education 5 — Questions and Answers
Question 1: A liver transplant recipient is being counseled about CMV infection. Which patient profile is at highest risk for CMV disease post-transplant?
- CMV-positive recipient receiving an organ from a CMV-positive donor
- CMV-negative recipient receiving an organ from a CMV-positive donor (Correct answer)
- CMV-positive recipient receiving an organ from a CMV-negative donor
- CMV-negative recipient receiving an organ from a CMV-negative donor
Correct answer: CMV-negative recipient receiving an organ from a CMV-positive donor
A CMV-negative recipient receiving a CMV-positive organ (D+/R-) carries the highest risk for primary CMV disease due to lack of pre-existing immunity.
Question 2: A patient newly listed for a kidney transplant asks what UNOS is and how it affects them. What is the best explanation?
- UNOS is a government agency that sets immunosuppression dosing protocols
- UNOS manages the national organ transplant waiting list and allocation policies that determine when and how organs are offered (Correct answer)
- UNOS provides financial assistance for transplant medications
- UNOS certifies transplant coordinators for professional licensure
Correct answer: UNOS manages the national organ transplant waiting list and allocation policies that determine when and how organs are offered
UNOS (United Network for Organ Sharing) operates the national waiting list and establishes policies governing how donated organs are allocated to candidates.
Question 3: A patient reports forgetting an evening dose of mycophenolate mofetil. What instruction should the coordinator give?
- Take double the next scheduled dose to compensate
- Take the missed dose as soon as remembered unless it is almost time for the next dose, then skip (Correct answer)
- Stop taking the medication and contact the transplant team before resuming
- Mycophenolate does not need to be taken every day, so no action is needed
Correct answer: Take the missed dose as soon as remembered unless it is almost time for the next dose, then skip
The general rule for a missed dose is to take it as soon as remembered unless it is near the next scheduled dose, at which point the missed dose is skipped.
Question 4: When educating a family about caring for a transplant recipient at home, which environmental precaution is most important in the early post-transplant period?
- Keep the patient in a completely sterile isolation room indefinitely
- Avoid exposing the patient to people with active infections and practice thorough hand hygiene (Correct answer)
- Disinfect all surfaces with industrial bleach daily
- Prohibit all family visitors for one full year
Correct answer: Avoid exposing the patient to people with active infections and practice thorough hand hygiene
Avoiding sick contacts and rigorous hand hygiene are practical, evidence-based measures to reduce infection risk without complete isolation.
Question 5: A pediatric kidney transplant patient's parents ask about school attendance post-transplant. What guidance should the coordinator provide?
- The child must be homeschooled permanently after transplantation
- Most children can return to school after the early recovery period with precautions such as avoiding sick classmates and good hand hygiene (Correct answer)
- School attendance is safe immediately after discharge without any precautions
- The child should attend only virtual school until immunosuppression is discontinued
Correct answer: Most children can return to school after the early recovery period with precautions such as avoiding sick classmates and good hand hygiene
With appropriate infection precautions, most pediatric recipients can safely return to school after the early recovery phase to support normal development.
Question 6: A transplant coordinator is discussing advance directives with a patient awaiting a liver transplant. Why is this discussion particularly important in this population?
- Transplant centers legally require advance directives before listing
- Patients face significant perioperative and long-term mortality risks, making end-of-life preferences important to document proactively (Correct answer)
- Advance directives reduce insurance premiums for transplant patients
- Advance directives are only relevant for patients over age 65
Correct answer: Patients face significant perioperative and long-term mortality risks, making end-of-life preferences important to document proactively
Transplant candidates face serious perioperative risks and long-term complications, making advance care planning an essential part of the pretransplant education process.
Question 7: A patient asks if they need to inform new healthcare providers about their transplant history. What should the coordinator advise?
- Only the transplant center needs to know about the transplant history
- Every healthcare provider including dentists and emergency physicians must always be informed of the transplant and current medications (Correct answer)
- Disclosing transplant history is optional if the patient feels comfortable
- Only surgeons and hospitalists need to be aware of the transplant
Correct answer: Every healthcare provider including dentists and emergency physicians must always be informed of the transplant and current medications
All providers must know about the transplant and immunosuppressive regimen to avoid harmful drug interactions, inappropriate vaccinations, and missed infection signs.
CCTC Patient and Family Education 5
A liver transplant recipient is being counseled about CMV infection.
Which patient profile is at highest risk for CMV disease post-transplant?