CCTC Pre-Transplant Candidate Evaluation 4

Question 1

A candidate for kidney-pancreas transplant has Type 1 diabetes with a hemoglobin A1c of 11.2%. What does this finding suggest about transplant candidacy?

Accepted Answer

Poor glycemic control may indicate need for optimization and assessment of end-organ complications

Answer

The patient is an ideal candidate due to severe diabetes

Answer

A1c level has no relevance to transplant eligibility

Answer

The patient should receive pancreas transplant alone first

Question 2

During pre-transplant evaluation, serologic testing reveals the candidate is HCV antibody positive. After direct-acting antiviral treatment, HCV RNA is undetectable. How does this affect listing?

Accepted Answer

Sustained virologic response (SVR) after antiviral treatment generally does not preclude transplant listing

Answer

The patient is permanently excluded due to prior HCV infection

Answer

The patient must wait 5 years after SVR before listing

Answer

HCV-treated patients can only receive HCV-positive donor organs

Question 3

A transplant candidate being evaluated for kidney transplant has a documented history of multiple episodes of medical non-compliance resulting in hospitalizations. How should the transplant team approach this?

Accepted Answer

Conduct thorough psychosocial assessment, identify barriers to adherence, and develop a plan before listing

Answer

Immediately list the patient since past behavior does not predict future outcomes

Answer

Permanently deny listing for all non-compliant patients

Answer

List the patient but assign lower priority on the waitlist

Question 4

What is the purpose of the 6-minute walk test (6MWT) in pre-transplant evaluation for heart or lung transplant candidates?

Accepted Answer

To objectively assess functional capacity and predict perioperative risk and post-transplant outcomes

Answer

To diagnose coronary artery disease

Answer

To determine MELD score components

Answer

To evaluate kidney function before transplant

Question 5

A 65-year-old kidney transplant candidate has no history of colon cancer but has never had a colonoscopy. What is the standard recommendation before listing?

Accepted Answer

Age-appropriate cancer screening including colonoscopy should be completed prior to transplant listing

Answer

No colonoscopy is needed for patients without symptoms

Answer

Colonoscopy is only required if the patient has a first-degree relative with colon cancer

Answer

Colonoscopy should be deferred until 1 year post-transplant

Question 6

Which finding would most likely lead to a thorough neurological evaluation before kidney transplant listing in an elderly candidate?

Accepted Answer

Cognitive impairment identified on the Montreal Cognitive Assessment (MoCA)

Answer

Well-controlled hypertension

Answer

History of a single uncomplicated febrile seizure 20 years ago

Answer

Mild peripheral neuropathy from diabetes

Question 7

A patient with autosomal dominant polycystic kidney disease (ADPKD) is being evaluated for kidney transplant and has massively enlarged kidneys causing abdominal discomfort and recurrent infections. What surgical consideration arises?

Accepted Answer

Native nephrectomy may be required to create adequate space for the transplanted kidney

Answer

The native kidneys must always be removed before transplant listing

Answer

ADPKD patients are never candidates for kidney transplant

Answer

The transplant kidney is placed in the native renal fossa requiring mandatory bilateral nephrectomy