CTP Donor & Recipient Evaluation 2 — Questions and Answers
Question 1: Which serological test is required to evaluate a potential organ donor for Epstein-Barr virus (EBV) status?
- EBV-VCA IgG and IgM (Correct answer)
- EBV PCR only
- Monospot test
- Complete blood count
Correct answer: EBV-VCA IgG and IgM
EBV-VCA IgG and IgM serology determines prior exposure versus active infection in organ donors.
Question 2: A potential kidney donor has a creatinine of 2.8 mg/dL that fails to normalize after hydration. What is the most appropriate next step?
- Decline the kidneys for transplant
- Obtain a donor kidney biopsy (Correct answer)
- Proceed with procurement and discard post-flush
- Increase vasopressor support and reassess in 12 hours
Correct answer: Obtain a donor kidney biopsy
A donor kidney biopsy provides histological data to guide the accept/decline decision when functional parameters are borderline.
Question 3: Which donor characteristic is an absolute contraindication to organ donation for transplantation?
- History of treated skin cancer
- Active untreated bacterial sepsis with multi-organ failure (Correct answer)
- Age over 70 years
- Hypertension managed with medication
Correct answer: Active untreated bacterial sepsis with multi-organ failure
Active untreated bacterial sepsis with multi-organ failure poses unacceptable risk of transmitting infection to an immunosuppressed recipient.
Question 4: The Panel Reactive Antibody (PRA) level in a recipient candidate primarily reflects:
- The recipient's current renal function
- The degree of recipient sensitization to HLA antigens (Correct answer)
- Compatibility with a specific donor ABO group
- The recipient's risk of primary non-function
Correct answer: The degree of recipient sensitization to HLA antigens
PRA measures the percentage of a panel of donor cells against which the recipient has pre-formed antibodies, indicating level of sensitization.
Question 5: Which imaging modality is most commonly used to evaluate donor liver anatomy and vascular patency prior to procurement?
- MRI with gadolinium
- CT angiography with contrast (Correct answer)
- Doppler ultrasound alone
- Plain abdominal X-ray
Correct answer: CT angiography with contrast
CT angiography provides detailed vascular anatomy including hepatic arterial variants critical for surgical planning.
Question 6: In evaluating a potential heart donor, which ECG finding would most raise concern about cardiac suitability?
- Sinus bradycardia at 55 bpm
- New left bundle branch block with ST changes (Correct answer)
- First-degree AV block (PR 210 ms)
- Isolated left axis deviation
Correct answer: New left bundle branch block with ST changes
New LBBB with ST changes in a donor may indicate acute myocardial injury, requiring further evaluation before cardiac procurement.
Question 7: When assessing a recipient for liver transplantation, the MELD score incorporates which three laboratory values?
- INR, serum creatinine, and serum bilirubin (Correct answer)
- ALT, AST, and albumin
- Platelet count, PT, and ammonia
- Sodium, potassium, and bicarbonate
Correct answer: INR, serum creatinine, and serum bilirubin
The MELD score uses INR, serum creatinine, and total bilirubin to predict 90-day mortality in patients with liver disease.
CTP Donor & Recipient Evaluation 2
Which serological test is required to evaluate a potential organ donor for Epstein-Barr virus (EBV) status?