CCTC - Certified Clinical Transplant Coordinator Pre-Transplant Candidate Evaluation Questions and Answers

Question 1

A 58-year-old male with end-stage renal disease is undergoing evaluation for kidney transplantation. Which of the following is considered an absolute contraindication to proceeding with the transplant?

Accepted Answer

An active, untreated malignancy

Answer

An active, untreated malignancy is an absolute contraindication for kidney transplantation. The required immunosuppressive therapy following transplant could accelerate cancer recurrence or metastasis. Other absolute contraindications include severe cardiac or pulmonary disease making surgery intolerable, active infection, and uncontrolled psychiatric disease. Morbid obesity, hypertension, and a history of non-adherence are typically considered relative contraindications that require management and careful consideration.

Question 2

During the pre-transplant psychosocial evaluation, which domain is assessed to determine the candidate's ability to manage the complex post-transplant medication regimen and follow-up appointments?

Accepted Answer

Health literacy and adherence potential

Answer

The psychosocial evaluation assesses multiple domains, but the candidate's health literacy and potential for adherence are specifically evaluated to gauge their ability to understand and follow the complex medical regimen required after transplantation. This includes managing medications, attending appointments, and monitoring their health. While social support, psychological health, and substance use history are also critical components of the overall assessment, they do not as directly address the cognitive and behavioral capacity for medical management.

Question 3

A potential liver transplant candidate has a history of significant coronary artery disease (CAD). As part of the cardiac evaluation, which of the following is a primary goal?

Accepted Answer

To determine the patient's long-term risk for cardiac events post-transplantation.

Answer

Cardiovascular disease is a leading cause of morbidity and mortality after liver and kidney transplantation. A primary goal of the pre-transplant cardiac evaluation is to perform a global assessment for both short- and long-term risk for major adverse cardiac events (MACE). This involves risk stratification that considers both the anatomic and functional consequences of CAD to ensure the candidate can survive the surgery and has a good long-term prognosis.

Question 4

Which of the following immunological tests is performed to determine a transplant candidate's sensitization to a broad panel of potential donor antigens?

Accepted Answer

Panel Reactive Antibody (PRA) screening

Answer

Panel Reactive Antibody (PRA) screening is used to test the recipient's serum for antibodies against a panel of cells representing the general donor population. A high PRA indicates a high degree of sensitization, which can make finding a compatible donor more difficult and increases the risk of rejection. HLA typing identifies the specific antigens of the recipient, ABO typing determines blood group compatibility, and CMV serology checks for past exposure to cytomegalovirus.

Question 5

A 45-year-old female is being evaluated for a lung transplant. Her infectious disease screening comes back positive for latent tuberculosis infection (LTBI) via a PPD skin test, with a negative chest X-ray. What is the most appropriate next step?

Accepted Answer

Initiate treatment for LTBI before or after transplantation.

Answer

Active infection is an absolute contraindication, but latent infection is not. For candidates with LTBI, the standard of care is to consider prophylactic therapy (e.g., with isoniazid) to prevent reactivation of the disease after post-transplant immunosuppression is initiated. The decision on the timing of treatment (before or after transplant) depends on the individual's clinical situation. Disqualification is not necessary, and waiting to repeat the test would cause an unnecessary delay.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Pre-Transplant Candidate Evaluation Questions and Answers