CCTC Pre-Transplant Candidate Evaluation 2

Question 1

A 58-year-old patient with end-stage renal disease has a panel reactive antibody (PRA) of 85%. What does this indicate for transplant planning?

Accepted Answer

The patient is highly sensitized and will have difficulty finding a compatible donor

Answer

The patient has a very low risk of rejection

Answer

The patient is an ideal candidate for living donor transplant only

Answer

The patient should be removed from the waiting list

Question 2

Which cardiac evaluation is typically required before listing a patient with diabetes mellitus for kidney transplantation?

Accepted Answer

Stress testing or coronary angiography to assess for occult coronary artery disease

Answer

Echocardiogram only

Answer

Chest X-ray and EKG only

Answer

Holter monitor for 24 hours

Question 3

A transplant candidate is found to have a positive PPD skin test with no prior BCG vaccination and no active symptoms. What is the appropriate management?

Accepted Answer

Prophylactic isoniazid (INH) therapy before and after transplant

Answer

Immediate removal from the transplant waitlist

Answer

No treatment needed unless active disease develops post-transplant

Answer

Rifampin therapy for 6 months prior to listing

Question 4

During pre-transplant psychosocial evaluation, a candidate discloses ongoing alcohol use despite prior treatment. What is the transplant team's most appropriate next step?

Accepted Answer

Require a mandatory sobriety period and engagement with addiction treatment before listing

Answer

List the patient immediately since alcohol use is not a contraindication

Answer

Refer to psychiatry and list the patient concurrently

Answer

Deny listing permanently due to substance use history

Question 5

Which finding on abdominal imaging would most concern the transplant team when evaluating a liver transplant candidate?

Accepted Answer

Portal vein thrombosis extending into the superior mesenteric vein

Answer

Small gallstones without cholecystitis

Answer

Mild splenomegaly

Answer

Small volume ascites responsive to diuretics

Question 6

A pre-transplant candidate has a BMI of 42 kg/m². How does this typically affect transplant listing decisions?

Accepted Answer

Morbid obesity is associated with increased perioperative risk and many centers require weight loss before listing

Answer

BMI has no impact on transplant outcomes or listing criteria

Answer

The patient should receive an immediate living donor transplant to avoid waitlist time

Answer

Only patients with BMI over 50 face any restrictions

Question 7

When performing a pre-transplant crossmatch, a T-cell flow cytometry crossmatch returns positive. What is the clinical implication?

Accepted Answer

The recipient has donor-specific antibodies against T-cell antigens, increasing hyperacute rejection risk

Answer

No clinical significance; transplant can proceed without modification

Answer

This result indicates ABO incompatibility

Answer

The result means the donor organ is not viable