CCTN: Lung and Heart Questions and Answers Updated 2026

CCTN: Lung and Heart Questions
and Answers Updated 2026
acuteMrejectionMwithMlungMtransplantsMandMtreatmentM-
MAnswerMtakesMplaceMatMleastMonceMinMallMlungMtransplantMrecipients,MusuallyMwithin
MtheMfirstM3Mmonths.MSymptomsMareMcoughing,MshortnessMofMbreath,Mweakness,Meleva
tedMtemp,MlowMbloodMo2Mlevels,MpulmonaryMinfiltrates,MandMpulmonaryMeffusions.MTrea
tmentMisMhigh-
doseMcorticosteroidsMandMproperMimmunosuppressiveMtherapy.MIfMleftMuntreated,Mchronic
MrejectionMwillMfollow.



chronicMrejectionMwithMlungMtransplantsM-
MAnswerMtypicallyMobservedMoneMyearMpostMtransplant.MChronicMlungMrejectionMcauses
MtheMbronchiolesMtoMbecomeMswollenMandMfibrose.MInflammationMcanMleadMtoMcomple
teMbronchioleMobstruction.MTreatmentMisMhighlyMindividualizedMandMtakesMintoMaccount
MtheMrecipientsMcurrentMimmunosuppressiveMregimen.MchronicMlungMrejectionMhasMaMde
athMrateMofM40%MorMhigherMatM3MyearsMpost-diagnosis.



bestMwayMtoMdiagnoseMacuteMandMchronicMrejectionMinMlungMtransplantsM-
MAnswerMdirectMmicroscopicMexaminationMofMtissueMfromMlavage,Mbrush,MfineMneedleMa
spiration,MtransbronchialMbiopsy,MorMwedgeMbiopsy.MLessMeffectiveMmethodsMincludeMche
stMx-ray,MpulmonaryMfunctionMtestsMandMbronchocopicMexamination.



differentMtypesMofMinfectionMrelatedMtoMlungMtransplantationM-
MAnswerMmorbidityMandMmortalityMinMlungMtransplantMpatientsMcommonlyMresultsMfrom
MinfectionMinMtheMfirstM3MmonthsMpostMtransplant.MCommonMinfectionsMincludeMearlyM
bacterialMpneumonia,MlateMbacterialMpneumonia,MCdiff,MFungal,MViralMorMparasites.



medicalMtestsMrecommendedMforMlungMtransplantMevaluationM-
MAnswerMchestMxrayMPAMandMlateral.MQuantitiativeMventilation-
perfusionMscan,MalsoMknownMasMVQMscanMwhichMisMdividedMintoM2MsectionsM1=injectio
nMofMcontrastMmediumMIVMhichMisMilluminatedMasMitMmovesMintoMtheMarteriesMofMlun
gsMindicatingMwhichMlungMreceivesMbetterMbloodMsupply.M2=patientMinhalesMcontrastMme
diumMtoMindicateMwhichMlungMtakesMinMmoreMo2MduingMinspiration.M12MleadMEKG.Mtr
ansesophagealMecho.MpulmonaryMfunctionMtests.MarterialMbloodMgases.Mo2MdesaturationM
study.M6-minuteMwalkingMdistance.MDEXAMscan.



whenMisMtimeMrightMforMaMlungMtransplantM-
MAnswerMobjectiveMandMsubjectiveMfactorsMareMusedMtoMdecideMwhenMtheMtimeMisMri
ghtMforMaMlungMtransplant.MTheMpatientMmustMmeetMcriteriaMsuchMasMlifeMexpectancy
MisM<24-

, 36MmonthsMwithoutMtransplant.MLungMdiseaseMcanMpotentiallyMaffectMtheMpatient'sMothe
rMorgans.MqualityMofMlifeMhasMsignificantlyMdeteriorated.MriskMvsMrewardMisMweighed.



ExplainMcriteriaMwhichMdeterminesMwhetherMsingleMorMdoubleMlungMtransplantM-
MAnswerMsingleMlungMtransplant=MCOPDMorMemphysema;MIPF;MAlphaMantitrypsinMdeficie
ncy,MprimaryMpulmonaryMhypertension.MDoubleMlungMtransplantM=McysticMfibrosis;Malpha
MantitrypsiMdeficiency,MprimaryMpulmonaryhypertensionMandMeasierMtoMtransplantMbothMl
ungsMandMheartMfromMaMcadaverMtoMpreserveMtheMvessels.



whatMareMtheMmostMcommonMviralMinfectionsMseenMwithMlungMtransplantsM-
MAnswerMCMVM-
MmostMtroublesomeMbecauseMitMleadsMtoMpneumonitisMwithMalveolarMdamage,Minclusion
s,MinfiltratesMandMbronchiolitisMobliterans.MOthersMincludeMherpesMsimplexMandMEBV.



howMtoMtreatMtheseMcommonMviralMinfectionsMseenMwithMlungMtransplantsM-
MAnswerM1.MtreatMeveryoneMwithMprophylacticMantiviralsMsuchMasMacyclovir,Mvalacyclovir
MandMIVMGanciclovir.M2.MfollowingMtheMdiscoveryMofMantigensMcirculatingMinMtheMblood
M(antigenemia),MgiveMweeklyMviralMchecksMforMtheMfirstM3MmonthsMpostMtransplantMan
dMafterM3MmonthsMconductMmonthlyMtests.



WhatMisMqualityMeffectMandMwhatMareM2MtypesMofMpatternsMassociatedMwithMit?M-
MAnswerMQualityMEffectM(QE)MisMtissueMlesionMfoundMonMtheMendocardiumMofMheartM
allograftMdueMtoMlymphocyticMinfiltration.MThisMhasMnoMclinicalMsignificanceMbutMstrong
MassociationMwithMacuteMrejection.M2MpatternsM=MQulityMAMwhichMisMnon-
invasiveMinflitrationMandMhasMnoMeffectMonMmyocardiumMandMQuiltyMBMwhichMisMinvas
iveMinfiltrationMwhichMinvolvesMmyocardiumMandMassociatedMwithMmyocyteMdaage.



ListMsomeMimportantMfactsMtoMconsiderMregardingMinfectionMinMpostMtransplantMheartM
patientsM-
MAnswerMLungsMareMmostMcommonMsiteMofMinfection.MAllMvirusesMareMworrisomeMsuc
hMasMCMV,MEBV,MHerepes,MvaricellaMzoster.MTORCHESMsyndrome=Mtoxoplasmosis,Mother
Magents,Mrubella,MCMV,Mherpes,MEBV,MandMsyphilisM-
McommonMinMnewbornsMwhoMareMsmall,MfeedMpoorly,Mjaundiced,Mpetechiae,MandMenlar
gedMspleen.



whatMisMtheMmostMfrequentMplaceMtoMbecomeMinfectedMwithMCMV?M-
MAnswerMgastrointestinalMtract



whatMvirusMhasMtheMgreatestMdeathMrate?M-MAnswerMCMV