CCTC Exam latest (2024\2025) verified
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CMV IGG & IGM (-)
✓ Not previously CMV infected
CMV IgG & IgM (+)
✓ Recent CMV infection
CMV IgG (+) & IgM (-)
✓ Past CMV infection, not recent
Blood Type O
✓ Universal Donor - Can receive subtype A2
Blood Type AB
✓ Universal Recipient
Kidney Priority Listing Criteria
✓ If candidate is prior living kidney donor
2) If there are 0 HLA-mismatches
Common causes of HLA Antibody production
✓ Transfusions
2) Pregnancy
3) Previous transplants
Hep C Ab
✓ Exposure to Hepatitis C
Hep B sAg
✓ Infection with hepatitis B
Hep B sAb
✓ Immune to hepatitis B
Hep B Core Antibody
✓ Previous hepatitis B infection or exposure
HLA Haplotypes
✓ A, B, DR
Rejection - Recognition step
✓ AP Cells
Rejection - Stimulation step
✓ T-Cells
Rejection - Defense step
✓ CD8 and B Cells
Immunosuppression balances 3 key factors
✓ Prevent rejection
2) Protect against infection and cancer
3) Guarantee efficacy
What organ is not allocated based on urgency?
✓ Kidney
How does UNOS prioritize?
✓ Medical urgency
2) Biological matching
Liver 1A Criteria includes
✓ Life expectancy <7 days
2) Hepatic artery thrombus
Heart 1A Criteria includes
✓ Mechanical circulatory support for acute hemodynamic decompensation
Lung Allocation Score (LAS) accounts for
✓ Formula estimating urgency and probability of long term survival
2) Pulmonary artery systolic pressure
3) O2 requirement
4) Need for continues mechanical ventilation
Long term risk of kidney donation
✓ HTN
Pre-transplant education should include
✓ Treatment options
2) Costs, and immunosuppression
3) Deceased donor criteria
What type of rejection is in first 6 months - likely to respond to increased immunosuppression?
✓ Acute cellular rejection
What urinary symptom is related to kidney transplant rejection?
✓ Decreased UOP
All pre-transplant kidney evals should obtain
✓ Hepatitis serologies
In the small intestine, most absorption occurs in:
✓ Duodenum and jejunum
In early post op period for intestinal transplant, scopes are completed
✓ Twice weekly weeks 1-6.
Nausea and vomiting may be caused by
✓ decreased gastric motility
Which side heart catheterization is required for Lung Allocation Score?
✓ Right heart catheterization
What is not an early complication in lung transplant?
✓ PTLD
Contributors to chronic lung transplant rejection (Bronchiolitis obliterans)
✓ RSV
2) Influenza infection
3) CMV pneumonitis
Covers doctor services for certain organ transplants
✓ Medicare Part B
Covers transplants under certain conditions at Medicare-certified hospitals
✓ Medicare Part A
Pays 80% of physician services, Patient pays 20%
✓ Medicare
How long is Medicare active if obtained solely due to ESRD?
✓ 3 years
Symptoms of CMV (general, outside of tissue invasive disease)
✓ Fever, malaise, arthralgia, leukopenia, thrombocytompenia
Term for chronic rejection in lung transplant
✓ Bronchiolitis obliterans
Leading cause of death in lung transplant beyond the first year
✓ Chronic rejection
Most common bacterial infection after liver transplant
✓ Cryptococcus
Most common organism in Spontaneous Bacterial Peritonitis
✓ Gram neg bacteria (e. Coli)
Normal heart rate post-heart transplant
✓ 100
Which kidney is preferred?
✓ Left
Which VS should be documented for ALL tx patients?
✓ Blood pressure and temperature
Signs and symptoms of intestinal rejection
✓ Intermittent low grade fever and high stoma output
In a heart/lung transplant, which rejects first?
✓ Lung
Cold ischemia time for heart
✓ 4 hours
Cold ischemia time for intestine
✓ 6 hours
Cold ischemia time for lung
✓ 8 hours
Cold ischemia time for liver
✓ 12 hours
Cold ischemia time for kidney
✓ 24 hours
Cold ischemia time for pancreas
✓ 12 hours
If candidate and recipient match one antigen each at HLA-A, B, and DR, this is called
✓ 1-haplotype match
Cramping in the legs associated with peripheral vascular disease
✓ Claudication
Extended criteria donors are at least 50 years old and have two of the following
✓ Stroke as cause of death
2) Hypertension
3) Creatinine greater than 1.5
4) 60 years old +
Best treatment option for HCV
✓ Interferon and ribavirin
Route Interferon is given
✓ SQ
Significant side effect of Interferon
✓ Depression
Which has lower surgical complication rates - BD OR ED Pancreas Transplant?
✓ BD
How often is the PRA tested in a transplant candidate with VAD?
✓ Weekly
High risk behavior criteria must have happened in the last how many years?
✓ 5
Which diagnostic procedure will evaluate CAV?
✓ Left heart cath
Which segment is typically donated in pediatric living donor liver transplant?
✓ Left lateral segment
Used to diagnose if biliary tract is patent has blockage
✓ ERCP
Osteopenia Bone density T-Score
✓ 1-2.5 SD below mean
Osteoporosis Bone density T-Score
✓ >2.5 SD below mean
Most common reported complication after liver donation surgery
✓ Biliary leaks
Signs of biliary leak
✓ New onset fever, leukocytosis, abdominal pain, persistent or increased bile leakage from drain
What indicates acute early rejection in enteric-drained pancreas transplant?
✓ Rise in serum amylase and lipase, graft tenderness
Two or more of the following characteristics are highest risk for cardiac complications
✓ Dialysis >3 years
2) Primary disease with atherosclerotic risk factors
3) Males > 45 years old
4) Ischemic heart disease in first degree relative
5) HTN
6) Current smoker
7) HDL < 35
8) Cholesterol > 200
Most common type of peritransplant fluid collection
✓ Lymphocele
MELD score range
✓ 6-40
At what MELD score do you consider the sodium
✓ MELD >11
MELD score calculated from
✓ Serum creatinine, serium bilirubin, INR, serum sodium
Labs that indicate nonfunction in liver
✓ Coags, glucose, potassium, lactate
Cholestatis symptoms
✓ Clay colored stool, dark urine, itching, pain in RUQ, jaundice
T-tube draining should be colored
✓ golden brown
First line test for HCV
✓ EIA
If HCV EIA is positive, use this test next
✓ HCV RNA (NAT)
Liver Listing Status 1A
✓ Fulminant, HAT, or decompensated Wilson's Disease
Liver Listing 1B
✓ Hepatoblastoma, metabolic
