CCTN Organ Procurement and Donor Evaluation 2 — Questions and Answers
Question 1: Which serologic test must be negative in a potential organ donor to prevent transmission of HIV to the transplant recipient?
- Anti-HCV antibody
- HIV-1/2 antibody and HIV NAT (nucleic acid testing) (Correct answer)
- HBsAg only
- CMV IgG
Correct answer: HIV-1/2 antibody and HIV NAT (nucleic acid testing)
Both HIV antibody testing and nucleic acid testing (NAT) are performed on donors to minimize the window period and prevent HIV transmission to recipients.
Question 2: What is the purpose of machine perfusion technology in organ preservation?
- To perform pre-implantation biopsy
- To continuously perfuse the organ with oxygenated solution, reducing ischemic injury and improving viability (Correct answer)
- To remove pathogens from the donor organ
- To precondition the organ with immunosuppressive agents
Correct answer: To continuously perfuse the organ with oxygenated solution, reducing ischemic injury and improving viability
Machine perfusion continuously delivers oxygenated preservation solution to the organ, reducing cold ischemia injury and allowing viability assessment beyond static cold storage.
Question 3: The Kidney Donor Profile Index (KDPI) is used for what purpose?
- To determine the recipient's risk of rejection
- To estimate the quality and expected function of a deceased donor kidney relative to the donor pool (Correct answer)
- To calculate the recipient's waiting time on the transplant list
- To predict graft survival based on immunosuppression regimen
Correct answer: To estimate the quality and expected function of a deceased donor kidney relative to the donor pool
KDPI uses donor characteristics to estimate kidney quality — a higher KDPI indicates a greater risk of graft failure compared to the average donor kidney.
Question 4: A potential organ donor has a history of treated hypertension and mild proteinuria. What step is most important before accepting the kidneys?
- Automatically decline the kidneys due to donor comorbidities
- Perform a donor kidney biopsy to assess histologic quality (Correct answer)
- Proceed with procurement without additional evaluation
- Check the donor's family history only
Correct answer: Perform a donor kidney biopsy to assess histologic quality
A biopsy helps assess the degree of glomerulosclerosis and arterial changes, informing the decision to use one or both kidneys or decline them.
Question 5: Which organization manages the national deceased donor organ allocation system in the United States?
- Centers for Medicare & Medicaid Services (CMS)
- United Network for Organ Sharing (UNOS) (Correct answer)
- American Society of Transplantation (AST)
- Joint Commission on Accreditation
Correct answer: United Network for Organ Sharing (UNOS)
UNOS manages the national Organ Procurement and Transplantation Network (OPTN) and oversees policies for organ allocation to ensure equitable distribution.
Question 6: What is the primary purpose of performing a liver biopsy on a donor liver before transplantation?
- To detect rejection before transplant
- To assess the degree of hepatic steatosis, which affects graft function (Correct answer)
- To match histocompatibility antigens
- To evaluate for hepatitis C
Correct answer: To assess the degree of hepatic steatosis, which affects graft function
Donor liver biopsy primarily assesses macrovascular steatosis — livers with greater than 30–40% steatosis have increased risk of primary non-function.
CCTN Organ Procurement and Donor Evaluation 2
Which serologic test must be negative in a potential organ donor to prevent transmission of HIV to the transplant recipient?