CCTC NATCO UPDATED ACTUAL Exam
Questions and CORRECT Answers
Pancreas - CORRECT ANSWER - Most candidates have type 1 diabetes
Poor hypoglycemic control, unawareness
Poor metabolic control
Candidates for pancreas transplant - CORRECT ANSWER - On insulin and C-peptide less
or equal to 2 ng/ml OR
On insulin and C-peptide greater or equal to 2 ng/ml AND a BMI less than or equal to the
maximum allowable BMI ( currently less or equal to 28 kg/m2
Pancreatic exocrine insufficiency
Patients with type 2 diabetes are seldom evaluated for pancreas transplant and account for 7% of
all pancreas transplant recipients in 2010
Native kidneys and pancreas are not removed during panc transplant - CORRECT
ANSWER - Allows the exocrine function of the native pancreas to be preserved
Two surgical approaches
Exocrine secretions are generally drained into - CORRECT ANSWER - Enteric drainage
OR
Bladder drainage
Enteric drainage bowel drainage - CORRECT ANSWER - Much of the 2 liter of exocrine
enzymatic fluid and bicarbonate produced by the pancreas is reabsorbed in the bowel
Enteric drainage - CORRECT ANSWER - The transplanted donor duodenal segment is
attached to recipients jejunum to establish exocrine drainage
, Bladder drainage - CORRECT ANSWER - The systematic bladder drainage technique
directs Venus outflow and insulin drainage into the iliac vein
The exocrine drainage is via anastomosis of a duodenal segment to the recipients urinary bladder
Benefit to bladder drainage - CORRECT ANSWER - That the rejection episodes in the
pancreas can be detected more readily by measuring the exocrine enzyme amylase in the urine
Bladder drainage Predispose the patient to - CORRECT ANSWER - Dehydration
Recurrent urinary tract infections especially if patient has a history of neurogenic bladder with
poor bladder emptying
Cystitis
Metabolic acidosis we're large mounds of sodium bicarbonate or emptied into the bladder
Reflux pancreatitis
Hematuria
Approximately 10 to 25% of BD recipients undergo a surgical procedure called enteric
conversion in the first five years following Transplant due to recurrent UTIs, large duodenal
leaks, severe or recurrent hematuria, or significant cystitis - CORRECT ANSWER -
When the pancreas is transplanted simultaneously with a kidney from the same donor, the kidney
conserve as early rejection detection mechanism - CORRECT ANSWER -
Average length of surgical procedure - CORRECT ANSWER - 48 hours for combined
kidney and pancreas transplant
3 to 4 hours isolated pancreas transplant
Post transplant course for pancreas transplant - CORRECT ANSWER - Average length of
stay 7 to 14 days
May require 24 to 48 hours stay in ICU
Nasogastric tube in place for approximately 1 to 2 days or until bowel function returns
Questions and CORRECT Answers
Pancreas - CORRECT ANSWER - Most candidates have type 1 diabetes
Poor hypoglycemic control, unawareness
Poor metabolic control
Candidates for pancreas transplant - CORRECT ANSWER - On insulin and C-peptide less
or equal to 2 ng/ml OR
On insulin and C-peptide greater or equal to 2 ng/ml AND a BMI less than or equal to the
maximum allowable BMI ( currently less or equal to 28 kg/m2
Pancreatic exocrine insufficiency
Patients with type 2 diabetes are seldom evaluated for pancreas transplant and account for 7% of
all pancreas transplant recipients in 2010
Native kidneys and pancreas are not removed during panc transplant - CORRECT
ANSWER - Allows the exocrine function of the native pancreas to be preserved
Two surgical approaches
Exocrine secretions are generally drained into - CORRECT ANSWER - Enteric drainage
OR
Bladder drainage
Enteric drainage bowel drainage - CORRECT ANSWER - Much of the 2 liter of exocrine
enzymatic fluid and bicarbonate produced by the pancreas is reabsorbed in the bowel
Enteric drainage - CORRECT ANSWER - The transplanted donor duodenal segment is
attached to recipients jejunum to establish exocrine drainage
, Bladder drainage - CORRECT ANSWER - The systematic bladder drainage technique
directs Venus outflow and insulin drainage into the iliac vein
The exocrine drainage is via anastomosis of a duodenal segment to the recipients urinary bladder
Benefit to bladder drainage - CORRECT ANSWER - That the rejection episodes in the
pancreas can be detected more readily by measuring the exocrine enzyme amylase in the urine
Bladder drainage Predispose the patient to - CORRECT ANSWER - Dehydration
Recurrent urinary tract infections especially if patient has a history of neurogenic bladder with
poor bladder emptying
Cystitis
Metabolic acidosis we're large mounds of sodium bicarbonate or emptied into the bladder
Reflux pancreatitis
Hematuria
Approximately 10 to 25% of BD recipients undergo a surgical procedure called enteric
conversion in the first five years following Transplant due to recurrent UTIs, large duodenal
leaks, severe or recurrent hematuria, or significant cystitis - CORRECT ANSWER -
When the pancreas is transplanted simultaneously with a kidney from the same donor, the kidney
conserve as early rejection detection mechanism - CORRECT ANSWER -
Average length of surgical procedure - CORRECT ANSWER - 48 hours for combined
kidney and pancreas transplant
3 to 4 hours isolated pancreas transplant
Post transplant course for pancreas transplant - CORRECT ANSWER - Average length of
stay 7 to 14 days
May require 24 to 48 hours stay in ICU
Nasogastric tube in place for approximately 1 to 2 days or until bowel function returns
