CTP Quality Control & Safety Procedures 4 — Questions and Answers
Question 1: What is the correct action if a labeling discrepancy is discovered between two organ packaging bags during transport?
- Halt transport, quarantine the organ, and immediately contact the OPO and transplant center (Correct answer)
- Relabel the outer bag and continue transport
- Proceed with transplant and report discrepancy post-operatively
- Discard the organ without notification
Correct answer: Halt transport, quarantine the organ, and immediately contact the OPO and transplant center
Any labeling discrepancy is a critical safety event requiring organ quarantine and immediate reporting to prevent misallocation.
Question 2: Which solution is most commonly used for static cold storage of kidneys in the United States?
- University of Wisconsin (UW) solution (Correct answer)
- Normal saline
- Lactated Ringer's solution
- Phosphate-buffered saline
Correct answer: University of Wisconsin (UW) solution
UW solution is the gold standard for kidney cold storage, providing optimal metabolic suppression and cellular protection.
Question 3: What does the term 'agonal phase' refer to in the context of donation after circulatory death (DCD)?
- The period between withdrawal of life support and cardiac arrest (Correct answer)
- The surgical incision phase of procurement
- The time from cardiac arrest to organ flush
- The recipient's post-operative recovery phase
Correct answer: The period between withdrawal of life support and cardiac arrest
The agonal phase in DCD refers to the interval from withdrawal of life support to circulatory cessation, during which warm ischemia begins accumulating.
Question 4: When must a near-miss safety event during organ procurement be reported?
- As soon as possible per OPO policy, typically within 24 hours (Correct answer)
- Only if the organ was ultimately transplanted
- At the annual quality review meeting
- Near-miss events are not required to be reported
Correct answer: As soon as possible per OPO policy, typically within 24 hours
Near-miss events must be reported promptly per OPO quality management policy to enable corrective action and prevent future harm.
Question 5: Which finding during procurement would most likely cause immediate organ discard without transplant team consultation?
- Evidence of active malignancy with high metastatic risk found in the donor (Correct answer)
- Mild donor hypertension history
- Minor surface contusion on the organ capsule
- Donor age over 55 years
Correct answer: Evidence of active malignancy with high metastatic risk found in the donor
Discovery of high-risk active malignancy during procurement typically results in organ discard due to unacceptable risk of cancer transmission to immunosuppressed recipients.
Question 6: Which quality metric is tracked to evaluate OPO performance under CMS Conditions for Coverage?
- Donation rate relative to donor potential (Correct answer)
- Recipient 10-year survival rate
- Procurement surgeon board certification status
- Number of transplant centers served
Correct answer: Donation rate relative to donor potential
CMS evaluates OPOs against donation rate metrics benchmarked against donor potential within their donation service area.
Question 7: What is the significance of maintaining accurate warm ischemia time documentation in DCD procurement?
- It directly impacts organ viability and the transplant team's acceptance decision (Correct answer)
- It is required only for billing purposes
- It determines the recipient's immunosuppression regimen
- It is tracked for insurance liability purposes only
Correct answer: It directly impacts organ viability and the transplant team's acceptance decision
Warm ischemia time accumulation during DCD procurement critically determines organ viability and informs the transplant team's decision to accept or decline the organ.
CTP Quality Control & Safety Procedures 4
What is the correct action if a labeling discrepancy is discovered between two organ packaging bags during transport?