CCTN Transplant Complications and Clinical Management

Question 1

A kidney transplant patient presents with fever, graft tenderness, and rising serum creatinine 10 days post-transplant. What is the most likely diagnosis?

Accepted Answer

Acute cellular rejection

Answer

Fever, graft tenderness, and rising creatinine in the first weeks post-transplant are classic signs of acute cellular rejection requiring biopsy confirmation.

Question 2

Post-transplant lymphoproliferative disorder (PTLD) is most strongly associated with which viral infection?

Accepted Answer

Epstein-Barr Virus (EBV)

Answer

PTLD is most strongly associated with Epstein-Barr Virus (EBV), particularly in EBV-naive recipients receiving organs from EBV-seropositive donors.

Question 3

BK virus nephropathy in renal transplant recipients is managed primarily by which intervention?

Accepted Answer

Reducing immunosuppression to allow immune control of the virus

Answer

BK nephropathy is managed by reducing immunosuppression to allow the recipient's immune system to control BK virus replication and limit nephropathy progression.

Question 4

Which complication is indicated by a sudden cessation of urine output, graft pain, and hematuria in an early post-kidney-transplant patient?

Accepted Answer

Renal vein thrombosis

Answer

Sudden anuria with graft pain and hematuria in the early post-transplant period suggests renal vein thrombosis, a surgical emergency requiring immediate intervention.

Question 5

What is the recommended prophylaxis for Pneumocystis jirovecii pneumonia (PJP) in solid organ transplant recipients?

Accepted Answer

Trimethoprim-sulfamethoxazole (TMP-SMX)

Answer

TMP-SMX (Bactrim) is the first-line prophylaxis for PJP in transplant recipients and also provides coverage against Toxoplasma and some urinary tract pathogens.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Transplant Complications and Clinical Management