ANSWERS 2026
Types of transplants - CORRECT ANSWER -cornea
heart
trachea
lung
liver
bowel
kidney
pancreas
skin
vascular
Reason for increased liver transplants - CORRECT ANSWER -
Cure for hep C; recipients must accept and sign consent to receive organ infected with hep C
Types of patients high risk of hep C AND high risk of potential to donate organs -
CORRECT ANSWER -Drug users
Pathway to organ donation - CORRECT ANSWER -1. ABO compatibility
2. HLA compatibility
3. Sensitization to HLA antigens
4. Donor needs complete physical to look for HIV/AIDS, cancer, hepatitis, glucose intolerance, electr
olyte balances
5. Psychological testing to ensure medication compliance
Referral process - CORRECT ANSWER -
Potential organ donor identified, healthcare team member (nurse) will call 1-800-447-
9477 (Donor Network of Arizona Referral Hotline). Keeping in mind that timely referral of patients
who meet the criteria for donation is crucial to this process.
,The Center for Medicare and Medicaid Services requires facilities and Donor Network of Arizona (D
NA) to identify specific clinical trigger to determine when patients should be referred. Clinical trigg
ers to refer patients within one hour are:
-
When a patient with a severe neuro injury or insult who is ventilated and has a Glasgow Coma Sc
ore < 5.
-
When withdrawal of support being considered before there is a plan to discontinue mechanical or
pharmacological support.
- At time of cardiac death (regardless if the patient has already been referred).
Hospitals should also call DNA at 1-800-447-9477 to report any of the following:
- Brain death testing is being discussed or planned
- Discussion of withdrawal of support
- EOL/Comfort care measures being considered
- if the family inquires about donation.
Who pays for transplants - CORRECT ANSWER -medicare/medicaid
How many lives can be saved by one person? - CORRECT ANSWER -
8 lives with organ, 100 with tissue
Clinical triggers - CORRECT ANSWER -
All patients with a severe brain injury requiring mechanical ventilation
Call immediately if:
- brain death testing being discussed
-
discussionv forv withdrawalv ofv ventilatorv orv vasopressorv supportv isv isv initiatedv byv familyv orv physicia
n
(terminalv weening)
- EOL/comfortv carev measuresv beingv considered
,v
Callv withinv 1v hourv if:
- GCSv 5v orv lessv andv ventilated
- Atv timev ofv cardiacv deathv (always)
Complicationsv ofv brainv deadv donor/ptv -v CORRECTv ANSWERv --v DI
- hyperglycemia
- reducedv thyroidv function
- hypotension
- acidv basev imbalances
Complicationsv ofv transplantv ptv -v CORRECTv ANSWERv --v infection
- rejection
- HTN
- hyperglycemia
- hyperlipidemia
- nephrotoxicity
AZv donorv networkv -v CORRECTv ANSWERv -OPOv /v UNOS
Howv tov knowv ifv ptv isv donorv candidatev (ICUv ptv only)v -v CORRECTv ANSWERv -
BRAINv DEATH
- absentv cerebralv &v brainv stemv functionv withv non-survivablev headv injury
- absentv CNv reflexes,v GCSv =v 3v (minimum),v flatv line
-dilatedv unreactivev pupilsv (bewarev ofv atropine)
- EEG:v Nov electricalv activity
- positivev apneav testv =v nov respiratoryv movementv andv increasedv CO2v level/respiratoryv acidosi
s
-
cerebralv angiography;v nov bloodv flowv seen
- radionuclidev CPPv scan;v allv white
- dov notv feelv painv sov dov notv needv analgesia
- dov notv needv sedation
,v
CIRCULATORYv DEATH
-
patientsv whov havev codedv andv diev withinv minutesv ofv lifev supportv removalv (notv COPD,v notv termin
al
weenv patients)
- circulatoryv collapse
-
Organsv recoveredv aſterv w/dv lifev support:v ptv dies,v limitedv familyv saysv goodbyev andv timev ofv death
v is
clocked,v thenv ptv broughtv backv inv tov ORv andv rehookedv upv tov lifev supportv tov oxygenatev organsv a
nd
-tissues
Donorv networkv assumesv HCPv rolev tov determinev howv tov preservev organ
s
Brainv reflexv testsv -v CORRECTv ANSWERv -
1.v corneal:v cottonv swabv acrossv eyeballv andv normalv responsev isv tov blink;v brainv deadv willv notv bli
nk
2
.v oculovestibularv test:v coldv waterv inv ptv ear;v normalv responsev isv eyesv deviatev tov thatv ear
3
.v earv vsv eyev irrigations???v Lookv thisv up
4.v Doll'sv eyes:v turnv patientsv headv andv normalv responsev isv eyesv forv deviatev tov oppositev side.v Brain
v dv eyesv willv followv direction.
ead
5.v swallowv andv gagv reflex:v mustv bev absentv forv brainv deadv tov bev determine
d
6
.v babinskiv returnsv uponv brainv death,v sov positivev babinskiv isv veryv bad
7.v apneav test:v determinev ifv ptv hasv anyv spontaneousv respirations.v Hyperoxygenatev forv 30v minutes;v
OTNv extubatingv patient,v justv turningv offv vent.v Keepv offv forv 4v mi
n
apneav testv -v CORRECTv ANSWERv --
RTv stopsv ventilatorv butv continuesv O2v therapyv tov lookv forv respiratoryv movementv orv triggerv tov bre
at
he.
- Donev forv 8-
10v minutesv sov there'sv timev forv CO2v levelv tov risev andv respiratoryv canv dov ABG
-
Everyonev requiredv atv bedsidev tov watchv forv lossv ofv hemodynamicv stability
-
positivev resultv ifv nov respiratoryv movementv andv increasingv CO2v =v nov ventilationv happeningv withinv
p
atient