CCTC Pre-Transplant Candidate Evaluation 3

Question 1

A candidate for liver transplant has a MELD score of 28. What does this score primarily reflect?

Accepted Answer

The 90-day mortality risk from liver disease and urgency for transplantation

Answer

The patient's quality of life and functional status

Answer

The patient's compatibility with potential donors

Answer

The expected post-transplant survival probability

Question 2

Which cancer history is generally considered an absolute contraindication to solid organ transplantation?

Accepted Answer

Active metastatic malignancy with no curative treatment available

Answer

Basal cell carcinoma treated 10 years ago with clear margins

Answer

Stage I breast cancer treated 5 years ago with no recurrence

Answer

Cervical carcinoma in situ treated successfully 3 years prior

Question 3

During nutritional assessment of a cirrhotic liver transplant candidate, severe sarcopenia is identified. Why is this clinically significant?

Accepted Answer

Sarcopenia is associated with increased waitlist mortality and worse post-transplant outcomes

Answer

Sarcopenia has no effect on transplant outcomes

Answer

Sarcopenia only affects kidney transplant candidates

Answer

Sarcopenic patients automatically receive MELD exception points

Question 4

A patient being evaluated for heart transplant has been treated for non-Hodgkin's lymphoma and has been in remission for 3 years. What is the standard approach to this history?

Accepted Answer

Apply disease-free interval criteria (typically 2-5 years) and assess recurrence risk with oncology

Answer

Automatic disqualification with no further evaluation

Answer

List immediately since 3 years is always sufficient

Answer

Require 10 years of remission before any transplant evaluation

Question 5

A potential kidney transplant candidate has significant bilateral iliac artery calcification on CT imaging. Why is this relevant to transplant evaluation?

Accepted Answer

Severe vascular disease may prevent adequate arterial anastomosis for the transplanted kidney

Answer

It affects only the patient's cardiac risk stratification

Answer

It is a contraindication to transplant in all cases

Answer

It only matters for pancreas transplant candidates

Question 6

A transplant coordinator notes that a candidate's calculated GFR has been declining during the waitlist period. What action is most appropriate?

Accepted Answer

Notify the transplant physician and update the candidate's status to reflect current kidney function

Answer

No action is needed until the patient requires dialysis

Answer

Remove the patient from the waitlist until GFR stabilizes

Answer

Immediately activate the patient as Status 1A

Question 7

Which pulmonary function test result would most likely prompt concern during pre-transplant evaluation for a non-pulmonary organ?

Accepted Answer

FEV1 of 38% predicted with diffusion capacity <40% predicted

Answer

FEV1/FVC ratio of 0.78

Answer

Mild restrictive pattern with TLC of 78% predicted

Answer

SpO2 of 95% at rest on room air