CCTN: Lung and Heart Questions with
Accurate Answers
acute rejection with lung transplants and treatment correct answer takes place at
least once in all lung transplant recipients, usually within the first 3 months.
Symptoms are coughing, shortness of breath, weakness, elevated temp, low
blood o2 levels, pulmonary infiltrates, and pulmonary effusions. Treatment is
high-dose corticosteroids and proper immunosuppressive therapy. If left
untreated, chronic rejection will follow.
best way to diagnose acute and chronic rejection in lung transplants correct
answer direct microscopic examination of tissue from lavage, brush, fine needle
aspiration, transbronchial biopsy, or wedge biopsy. Less effective methods include
chest x-ray, pulmonary function tests and bronchocopic examination.
chronic rejection with lung transplants correct answer typically observed one year
post transplant. Chronic lung rejection causes the bronchioles to become swollen
and fibrose. Inflammation can lead to complete bronchiole obstruction.
Treatment is highly individualized and takes into account the recipients current
immunosuppressive regimen. chronic lung rejection has a death rate of 40% or
higher at 3 years post-diagnosis.
Define acute rejection for heart. correct answer usually occurs in first few
months. It is rejection at a cellular level.
Define chronic rejection for heart. correct answer more than 6 months post
transplant. It is intersitial; insidious.
, Define hyperacute rejection for heart. correct answer Rare. Occurs immedietly in
the first minutes. It is a humoral rejection with hasty tissue death seen because of
allograft failure; usually lethal.
describe guidelines used in deciding if a heart is appropriate for donation. correct
answer Age of donor must be less than 50. arterial o2 saturation must be greater
than 80% with the use of a ventilator. If those 2 criteria are met it procedes to
these seven:1=no current infections. 2=no cancer located outside of the cranium.
3=no ventricular arrhythmias of significant concern. 4=no HIV/AIDS, Hep B or C.
5=No history of heart disease, including heart attack or coronary artery disase.
6=no heart structure abnormalities. 7=no IV drug use history.
Describe orthotopic and heterotopic transplantation correct answer orthotopic =
more common of the 2 procedures, diseased heart is remoed and replaced by a
donor heart in normal anatomical position. Heterotopic = rarely performed due to
high risk. Recipient diseased heart left in place and donor heart transplanted in
receipient right chest cavity - called piggybacking. Then the vascular structures of
the recipients and donor hears are connected using end-to-side anastomosis.
different types of infection related to lung transplantation correct answer
morbidity and mortality in lung transplant patients commonly results from
infection in the first 3 months post transplant. Common infections include early
bacterial pneumonia, late bacterial pneumonia, Cdiff, Fungal, Viral or parasites.
Explain criteria which determines whether single or double lung transplant
correct answer single lung transplant= COPD or emphysema; IPF; Alpha
antitrypsin deficiency, primary pulmonary hypertension. Double lung transplant =
cystic fibrosis; alpha antitrypsi deficiency, primary pulmonaryhypertension and
easier to transplant both lungs and heart from a cadaver to preserve the vessels.
Accurate Answers
acute rejection with lung transplants and treatment correct answer takes place at
least once in all lung transplant recipients, usually within the first 3 months.
Symptoms are coughing, shortness of breath, weakness, elevated temp, low
blood o2 levels, pulmonary infiltrates, and pulmonary effusions. Treatment is
high-dose corticosteroids and proper immunosuppressive therapy. If left
untreated, chronic rejection will follow.
best way to diagnose acute and chronic rejection in lung transplants correct
answer direct microscopic examination of tissue from lavage, brush, fine needle
aspiration, transbronchial biopsy, or wedge biopsy. Less effective methods include
chest x-ray, pulmonary function tests and bronchocopic examination.
chronic rejection with lung transplants correct answer typically observed one year
post transplant. Chronic lung rejection causes the bronchioles to become swollen
and fibrose. Inflammation can lead to complete bronchiole obstruction.
Treatment is highly individualized and takes into account the recipients current
immunosuppressive regimen. chronic lung rejection has a death rate of 40% or
higher at 3 years post-diagnosis.
Define acute rejection for heart. correct answer usually occurs in first few
months. It is rejection at a cellular level.
Define chronic rejection for heart. correct answer more than 6 months post
transplant. It is intersitial; insidious.
, Define hyperacute rejection for heart. correct answer Rare. Occurs immedietly in
the first minutes. It is a humoral rejection with hasty tissue death seen because of
allograft failure; usually lethal.
describe guidelines used in deciding if a heart is appropriate for donation. correct
answer Age of donor must be less than 50. arterial o2 saturation must be greater
than 80% with the use of a ventilator. If those 2 criteria are met it procedes to
these seven:1=no current infections. 2=no cancer located outside of the cranium.
3=no ventricular arrhythmias of significant concern. 4=no HIV/AIDS, Hep B or C.
5=No history of heart disease, including heart attack or coronary artery disase.
6=no heart structure abnormalities. 7=no IV drug use history.
Describe orthotopic and heterotopic transplantation correct answer orthotopic =
more common of the 2 procedures, diseased heart is remoed and replaced by a
donor heart in normal anatomical position. Heterotopic = rarely performed due to
high risk. Recipient diseased heart left in place and donor heart transplanted in
receipient right chest cavity - called piggybacking. Then the vascular structures of
the recipients and donor hears are connected using end-to-side anastomosis.
different types of infection related to lung transplantation correct answer
morbidity and mortality in lung transplant patients commonly results from
infection in the first 3 months post transplant. Common infections include early
bacterial pneumonia, late bacterial pneumonia, Cdiff, Fungal, Viral or parasites.
Explain criteria which determines whether single or double lung transplant
correct answer single lung transplant= COPD or emphysema; IPF; Alpha
antitrypsin deficiency, primary pulmonary hypertension. Double lung transplant =
cystic fibrosis; alpha antitrypsi deficiency, primary pulmonaryhypertension and
easier to transplant both lungs and heart from a cadaver to preserve the vessels.
