CCTN Organ Procurement and Donor Evaluation 1 — Questions and Answers
Question 1: Which criterion must be met before a patient can be declared brain dead for organ donation purposes?
- Absent pupillary reflexes alone
- Irreversible cessation of all brain functions including the brainstem confirmed by two physicians (Correct answer)
- Flat EEG for 24 hours
- Cardiac arrest followed by resuscitation failure
Correct answer: Irreversible cessation of all brain functions including the brainstem confirmed by two physicians
Brain death requires irreversible cessation of all brain functions including the brainstem, confirmed by two qualified physicians using established clinical criteria.
Question 2: What is the role of an Organ Procurement Organization (OPO) in the transplant process?
- It provides immunosuppressive medications to transplant recipients
- It coordinates organ donation, evaluation, allocation, and procurement from deceased donors (Correct answer)
- It manages the transplant waiting list
- It performs transplant surgeries at regional hospitals
Correct answer: It coordinates organ donation, evaluation, allocation, and procurement from deceased donors
OPOs coordinate all aspects of deceased donor organ procurement, including family consent, donor evaluation, organ allocation, and logistics.
Question 3: Cold ischemia time refers to which period in organ transplantation?
- Time from cross-clamp to organ reperfusion in the recipient
- Time the organ spends in warm conditions before preservation
- Time between organ procurement and transplantation into the recipient (Correct answer)
- Time from brain death declaration to procurement
Correct answer: Time between organ procurement and transplantation into the recipient
Cold ischemia time is the period from organ procurement and cooling to transplantation and reperfusion, during which the organ is preserved in cold storage solution.
Question 4: Which preservation solution is most commonly used for kidney preservation during cold storage?
- Normal saline
- University of Wisconsin (UW) solution (Correct answer)
- Lactated Ringer's solution
- Phosphate-buffered saline
Correct answer: University of Wisconsin (UW) solution
University of Wisconsin (UW) solution is the gold standard preservation fluid for kidney cold storage due to its composition that reduces ischemic cell damage.
Question 5: Donation after Circulatory Death (DCD) differs from Donation after Brain Death (DBD) in what key way?
- DCD organs are only used for tissue donation
- DCD occurs after cessation of cardiac function rather than brain death declaration (Correct answer)
- DCD requires family refusal of brain death criteria
- DCD is only applicable in pediatric donors
Correct answer: DCD occurs after cessation of cardiac function rather than brain death declaration
In DCD, organ donation proceeds after the planned withdrawal of life support and confirmation of circulatory death, rather than after brain death declaration.
Question 6: Which factor most significantly limits the acceptable cold ischemia time for heart transplantation compared to kidney transplantation?
- Heart size compatibility requirements
- The heart's sensitivity to ischemia makes the acceptable cold ischemia time much shorter (4–6 hours vs. 24–36 hours) (Correct answer)
- Heart transplants require more extensive HLA matching
- Cardiac preservation solutions are less effective
Correct answer: The heart's sensitivity to ischemia makes the acceptable cold ischemia time much shorter (4–6 hours vs. 24–36 hours)
The heart is highly sensitive to ischemic injury, limiting acceptable cold ischemia time to approximately 4–6 hours, compared to 24–36 hours for kidneys.
CCTN Organ Procurement and Donor Evaluation 1
Which criterion must be met before a patient can be declared brain dead for organ donation purposes?