Transplant Complications and Clinical Management Flashcards

Cytomegalovirus (CMV) infection in transplant recipients is most severe in which donor-recipient combination?

Answer: CMV donor positive / recipient negative (D+/R-)

The D+/R- combination carries the highest CMV risk because the recipient has no prior immunity against primary CMV infection transmitted from the seropositive donor.

Renal artery stenosis after kidney transplantation typically presents with which clinical findings?

Answer: Hypertension that is difficult to control and rising creatinine

Transplant renal artery stenosis classically presents with refractory hypertension and worsening allograft function, often diagnosed by Doppler ultrasound.

A liver transplant patient develops ascites and elevated liver enzymes 2 weeks post-operatively. What complication should be suspected first?

Answer: Hepatic artery thrombosis

Hepatic artery thrombosis is a serious early complication of liver transplant that compromises biliary and hepatic perfusion, presenting with liver dysfunction and ascites.

What is the most important nursing assessment parameter in the first 24 hours after kidney transplantation?

Answer: Hourly urine output measurement

Hourly urine output is the most critical early indicator of graft function — sudden decrease can indicate vascular complications, obstruction, or rejection.

Which post-transplant complication is caused by lymphatic disruption during surgery and typically presents as a fluid collection near the kidney?

Answer: Lymphocele

Lymphocele is a collection of lymphatic fluid that forms near the transplanted kidney due to lymphatic disruption during surgery and may compress the ureter or iliac vein.

Post-transplant erythrocytosis (PTE) in kidney transplant recipients is best managed by which medication class?

Answer: ACE inhibitors or angiotensin receptor blockers

ACE inhibitors and ARBs effectively reduce erythrocytosis in post-transplant patients by decreasing erythropoietin-stimulated red cell production.