CCTC NATCO CERTIFICATION ACTUAL EXAM PREP 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND REVISED

1|Page



CCTC NATCO CERTIFICATION ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED

1. A 54-year-old male with end-stage liver disease is being evaluated for
transplant. Which finding would be an absolute contraindication to liver
transplantation?
A. Hepatocellular carcinoma within Milan criteria
B. Active sepsis with positive blood cultures
C. Portal hypertension with varices
D. Hepatic encephalopathy
Correct Answer: B
Rationale: Active sepsis is an absolute contraindication to solid organ
transplantation due to the high risk of perioperative mortality from
immunosuppression-related infection. Hepatocellular carcinoma
within Milan criteria is a standard indication, and portal hypertension
with varices and hepatic encephalopathy are expected findings in
ESLD that are not contraindications.
2. A patient is being evaluated for kidney transplantation. Which of the
following is a relative contraindication?
A. HIV infection with undetectable viral load on ART
B. Untreated active malignancy
C. Active tuberculosis
D. Ongoing substance abuse
Correct Answer: A
Rationale: HIV infection with well-controlled viral load on ART is
now considered a relative rather than an absolute contraindication to
kidney transplantation. Untreated active malignancy, active

,2|Page


tuberculosis, and ongoing substance abuse are generally considered
absolute or strong relative contraindications.
3. A 65-year-old with COPD is being evaluated for lung transplantation.
Which factor is most important in determining candidacy?
A. Age alone
B. The patient's functional status and absence of other significant
comorbidities
C. Smoking history
D. Body Mass Index
Correct Answer: B
Rationale: Functional status and careful assessment of comorbidities
are critical in determining lung transplant candidacy. Age alone is not
a sole contraindication; smoking history and BMI are important but
secondary to overall functional and comorbidity assessment.
4. Which laboratory finding is most indicative of a CMV serostatus
indicating a past infection?
A. CMV IgG (+) & IgM (+)
B. CMV IgG (+) & IgM (-)
C. CMV IgG (-) & IgM (-)
D. CMV IgG (-) & IgM (+)
Correct Answer: B
Rationale: CMV IgG (+) and IgM (-) indicates a past CMV infection
with immunity. CMV IgG (+) & IgM (+) indicates a recent infection;
CMV IgG (-) & IgM (-) indicates no previous exposure, and CMV IgG
(-) & IgM (+) indicates a primary acute infection.
5. According to UNOS/OPTN kidney allocation policy, which of the
following candidates receives the highest priority for kidney allocation?
A. A candidate with a high Calculated Panel Reactive Antibody (CPRA)
B. A candidate who is a previous living kidney donor
C. A candidate with 0 HLA mismatches
D. A candidate with a long dialysis vintage

,3|Page


Correct Answer: B
Rationale: Previous living kidney donors receive priority in kidney
allocation. While high CPRA, 0 HLA mismatches, and long dialysis
vintage are factors, priority is given to those who have previously
donated a kidney.
6. A patient with end-stage renal disease is being evaluated for a kidney
transplant. Which of the following is an absolute contraindication to
transplantation?
A. Diabetes mellitus
B. Active malignancy
C. Hypertension
D. Hepatitis C infection
Correct Answer: B
Rationale: Active malignancy is an absolute contraindication to
transplantation due to the risk of accelerated tumor growth under
immunosuppression. Diabetes, hypertension, and hepatitis C (with
treatment) are not absolute contraindications.
7. Which of the following is the primary cause of chronic kidney disease
(CKD) leading to transplantation?
A. Diabetes mellitus
B. Hypertension
C. Glomerulonephritis
D. Polycystic kidney disease
Correct Answer: A
Rationale: Diabetes mellitus is the most common cause of CKD
leading to end-stage renal disease and transplantation. Hypertension
and glomerulonephritis are also common causes, but diabetes remains
the leading cause.
8. A patient with a history of non-adherence to medical regimens is
being evaluated for liver transplantation. What is the most appropriate
next step?

, 4|Page


A. List the patient immediately
B. Require a comprehensive psychosocial evaluation
C. List the patient without further assessment
D. Require a higher MELD score
Correct Answer: B
Rationale: A history of non-adherence requires a comprehensive
psychosocial evaluation to assess the patient's willingness and ability
to adhere to a complex post-transplant regimen. Non-adherence is a
significant risk factor for graft loss.
9. Which blood type is considered the universal donor for red blood
cells?
A. Type A
B. Type B
C. Type AB
D. Type O
Correct Answer: D
Rationale: Type O is the universal red blood cell donor because it
lacks A and B antigens and can be transfused to patients of any blood
type. Type AB is the universal recipient.
10. Which blood type is considered the universal recipient?
A. Type A
B. Type B
C. Type AB
D. Type O
Correct Answer: C
Rationale: Type AB is the universal recipient because it has no anti-A
or anti-B antibodies and can receive blood from any blood type. Type
O is the universal donor.
11. A patient with end-stage liver disease has a MELD score of 28. What
is the significance of this score?
A. The patient has a low risk of mortality and can wait longer