CCTN Transplant Complications and Clinical Management 3

Question 1

What is the first-line treatment for acute cellular rejection confirmed by biopsy?

Accepted Answer

High-dose intravenous corticosteroids (pulse steroids)

Answer

High-dose IV methylprednisolone (pulse steroids) is the first-line treatment for acute cellular rejection, typically given for 3–5 days.

Question 2

Calcineurin inhibitor nephrotoxicity can be distinguished from acute rejection by which finding?

Accepted Answer

CNI nephrotoxicity is associated with high drug levels and tubular vacuolization without significant inflammation

Answer

CNI nephrotoxicity typically shows isometric tubular vacuolization on biopsy with elevated drug levels, while rejection shows inflammatory cell infiltration.

Question 3

A pancreas transplant recipient develops hyperglycemia 1 week post-transplant. What is the most urgent complication to rule out?

Accepted Answer

Pancreatic graft thrombosis

Answer

Pancreatic graft thrombosis is the most common cause of early pancreas graft loss and presents with sudden hyperglycemia — vascular imaging is urgently required.

Question 4

Which statement about calcineurin inhibitor-induced hypertension in transplant recipients is accurate?

Accepted Answer

It affects over 50% of transplant recipients and increases cardiovascular risk

Answer

CNI-induced hypertension affects the majority of transplant recipients and significantly contributes to cardiovascular morbidity and mortality in this population.

Question 5

A kidney transplant recipient's serum creatinine rises from 1.2 to 2.8 mg/dL at 6 months post-transplant without symptoms. What is the recommended next step?

Accepted Answer

Obtain a kidney transplant biopsy to determine the cause

Answer

A significant rise in creatinine requires biopsy to differentiate between rejection, CNI toxicity, BK nephropathy, and other causes before initiating treatment.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Transplant Complications and Clinical Management 3