CCTC Transplant Immunology and Pharmacology 3

Question 1

A liver transplant recipient develops biopsy-proven acute cellular rejection on day 10. AST is 450 U/L. What is the first-line treatment?

Accepted Answer

High-dose pulse methylprednisolone (500–1000 mg IV daily × 3 days)

Answer

High-dose IV methylprednisolone pulse therapy is the standard first-line treatment for acute cellular rejection in liver transplant recipients.

Question 2

Which immunosuppressant acts by inhibiting inosine monophosphate dehydrogenase (IMPDH), thereby blocking de novo purine synthesis?

Accepted Answer

Mycophenolate mofetil

Answer

Mycophenolate mofetil is converted to mycophenolic acid (MPA), which selectively inhibits IMPDH, blocking de novo purine synthesis that lymphocytes depend on.

Question 3

In the context of transplantation, what does a positive crossmatch using complement-dependent cytotoxicity (CDC) indicate?

Accepted Answer

The recipient has preformed antibodies that lyse donor lymphocytes

Answer

A positive CDC crossmatch indicates recipient serum contains preformed antibodies that bind donor lymphocytes and, with complement, cause their lysis—a contraindication to transplant.

Question 4

Which of the following best describes the mechanism of antithymocyte globulin (ATG) in transplant immunosuppression?

Accepted Answer

Polyclonal antibodies that deplete T lymphocytes via complement and ADCC

Answer

ATG is a polyclonal antibody preparation that depletes T lymphocytes through complement-mediated lysis and antibody-dependent cellular cytotoxicity (ADCC).

Question 5

A transplant coordinator is reviewing immunosuppression for a patient with EBV-negative serostatus receiving a kidney from an EBV-positive donor. What post-transplant complication requires heightened monitoring?

Accepted Answer

Post-transplant lymphoproliferative disorder (PTLD)

Answer

EBV-seronegative recipients receiving organs from EBV-positive donors are at high risk for PTLD because primary EBV infection occurs in the setting of intense immunosuppression.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Transplant Immunology and Pharmacology 3