CTP CTP Transplant Pharmacology & Preservation Solutions 2 — Questions and Answers
Question 1: Immunosuppressant medications given during organ preservation flush are intended primarily to:
- Prevent early acute rejection at reperfusion (Correct answer)
- Sterilize the organ from bacterial contamination
- Enhance metabolic activity of preserved cells
- Improve cold ischemia tolerance
Correct answer: Prevent early acute rejection at reperfusion
Immunosuppressants administered during the preservation flush help blunt the early immune response upon reperfusion, reducing the risk of hyperacute or acute rejection.
Question 2: Which vasoactive agent is commonly added to preservation flushes to achieve maximal vasodilation of the donor organ vasculature?
- Prostaglandin E1 (PGE1) (Correct answer)
- Epinephrine
- Norepinephrine
- Vasopressin
Correct answer: Prostaglandin E1 (PGE1)
Prostaglandin E1 is a potent vasodilator added to preservation flushes to ensure uniform distribution of the solution throughout the organ's microvasculature.
Question 3: In the context of organ preservation, what does the term 'cold ischemia time' (CIT) specifically refer to?
- Time from cold flush to reperfusion in the recipient (Correct answer)
- Time from donor cross-clamp to procurement completion
- Time from organ retrieval to arrival at the transplant center
- Time from preservation flush to cold storage initiation
Correct answer: Time from cold flush to reperfusion in the recipient
Cold ischemia time begins when the organ is flushed with cold preservation solution and ends when blood flow is restored to the organ in the recipient.
Question 4: Which electrolyte concentration in preservation solutions most closely mimics intracellular fluid to protect cells during hypothermic storage?
- High potassium, low sodium (Correct answer)
- High sodium, low potassium
- Equal sodium and potassium
- High calcium, low magnesium
Correct answer: High potassium, low sodium
Intracellular-type preservation solutions with high potassium and low sodium mimic the intracellular environment, preventing the electrolyte shifts that cause cellular dysfunction during cold storage.
Question 5: What is the maximum acceptable cold ischemia time (in hours) for a standard-criteria kidney transplant to achieve optimal outcomes?
- 24 hours (Correct answer)
- 12 hours
- 36 hours
- 48 hours
Correct answer: 24 hours
Kidney transplants are ideally performed within 24 hours of cold ischemia time, as prolonged cold storage significantly increases the risk of delayed graft function.
Question 6: Celsior solution, developed primarily for cardiac preservation, contains which combination of components that distinguish it from UW solution?
- Histidine, mannitol, glutathione — without HES (Correct answer)
- Lactobionate, raffinose, HES
- Albumin, dextran, potassium
- Phosphate buffer, adenosine, glutathione
Correct answer: Histidine, mannitol, glutathione — without HES
Celsior contains histidine as a buffer, mannitol as an impermeant, and glutathione as an antioxidant, but lacks the hydroxyethyl starch colloid found in UW solution.
CTP CTP Transplant Pharmacology & Preservation Solutions 2
Immunosuppressant medications given during organ preservation flush are intended primarily to: