CCTC Pre-Transplant Candidate Evaluation 5

Question 1

A potential liver transplant candidate with alcoholic cirrhosis has been abstinent from alcohol for 4 months. Most transplant centers require a minimum of how long of documented sobriety?

Accepted Answer

6 months

Answer

1 month

Answer

2 years

Answer

18 months

Question 2

During pre-transplant evaluation, a kidney candidate's echocardiogram reveals an ejection fraction of 30% with dilated cardiomyopathy. What is the most appropriate next step?

Accepted Answer

Refer to cardiology for optimization of heart failure therapy and reassess cardiac function before finalizing listing

Answer

List the patient immediately as this is common in dialysis patients

Answer

Automatically deny listing due to low ejection fraction

Answer

Proceed with transplant listing but note the finding in the chart

Question 3

A pre-transplant candidate has an incidental finding of a 2 cm renal mass on imaging during kidney transplant evaluation. What should occur before listing?

Accepted Answer

Obtain further characterization with CT or MRI and urology consultation to exclude malignancy

Answer

Ignore the finding as the patient already has end-stage renal disease

Answer

Remove the patient from evaluation and recommend palliative care

Answer

List immediately and plan to monitor the mass post-transplant

Question 4

What is the primary goal of recipient HLA typing performed during pre-transplant evaluation?

Accepted Answer

To identify the recipient's HLA antigens for crossmatch testing and identifying unacceptable antigens

Answer

To calculate the patient's MELD score

Answer

To determine ABO blood type compatibility

Answer

To screen for genetic diseases that may recur after transplant

Question 5

A transplant coordinator is reviewing a candidate's medication history and notes prolonged use of high-dose NSAIDs. Why is this particularly relevant for kidney transplant evaluation?

Accepted Answer

NSAIDs are directly nephrotoxic and may have accelerated kidney disease progression

Answer

NSAIDs interact with transplant immunosuppressants making them contraindicated post-transplant

Answer

NSAID use indicates the patient will be non-compliant post-transplant

Answer

Long-term NSAID use is a contraindication to kidney transplant listing

Question 6

When obtaining informed consent for transplant listing, which element is most critical for the transplant coordinator to ensure the candidate understands?

Accepted Answer

The risks, benefits, alternatives, and lifelong commitment to immunosuppression and medical follow-up required after transplant

Answer

The names of all surgical team members

Answer

The estimated cost of each immunosuppressive medication

Answer

The exact waitlist position they will receive upon listing

Question 7

A transplant candidate is found to have a serum ferritin of 3,200 ng/mL and transferrin saturation of 62% during pre-transplant labs. What workup should be initiated?

Accepted Answer

Evaluation for hereditary hemochromatosis including HFE gene mutation testing and liver biopsy if indicated

Answer

No further evaluation is needed as elevated ferritin is common in dialysis patients

Answer

Immediate referral for bone marrow biopsy to evaluate for malignancy

Answer

Start iron chelation therapy and list the patient simultaneously