EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
CCTC review Study Guide with
Complete Solutions
Procedure for liver transplant - Answer✔✔-Anastomosis of the inferior vena cava, portal vein,
hepatic artery, and the biliary connection via a duct to duct anastomosis (
choledochocholeclochostomy)
Etiology of renal dysfunction immediately post op(liver tx) - Answer✔✔-Hypotensive episodes,
blood loss, high renal vein pressure intraoperatively and postoperatively due to
hemodynamically instability or sepsis.
Leading cause of non graft related death for liver recipients - Answer✔✔-Cardiorespiratory
failure
Which immunosuppressants cause HTN - Answer✔✔-Calcineurin inhibitors or corticosteroids
Which lab to monitor with fever post tx - Answer✔✔-Crp- c reactive protein because protein
present with acute inflammation and sepsis
Indicative of rejection - Answer✔✔-Light stools and dark urine,
Indicative of poor graft function s/p liver transplant - Answer✔✔-High lactate and acidosis, high
ALT/AST, PT >25 sec and continues to rise after vit k and FFP
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,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
type 2 diabetes - Answer✔✔-More common, occurs in adulthood, characterized by insulin
resistance. As resistance rise, beta cells are eventually unable to produce necessary amount of
insulin to lower and maintain normal blood glucose levels.
type 1 diabetes mellitus - Answer✔✔-diabetes in which no beta-cell production of insulin occurs
and the patient is dependent on insulin for survival
Goal of pancreas transplant - Answer✔✔-To restore normoglycemia, halt or prevent secondary
complications of diabetes
Indications for pancreas transplant alone (PTA) or pancreas after kidney (PAK) transplant -
Answer✔✔-Type 1 DM manifested by poor metabolic control, especially hypoglycemic
unawareness for many years. On insulin and C-peptide at or < 2 ng/ml or on insulin and C-
peptide at or greater than 2ng/mg and BMI at or less than maximum allowable BMI (currently
28) and pancreatic exocrine insufficiency.
Indications for Simultaneous pancreas-kidney (SPK) transplant - Answer✔✔-Diagnosis of
diabetes or pancreatic exocrine insufficiency with renal insufficiency
Immunosuppressive medications are covered by which part of Medicare? - Answer✔✔-
Medicare part B
Standard immunosuppressive for pancreas transplant recipients typically includes: -
Answer✔✔-Tacrolimus(prograf, FK506), mycophenolate mofetil (cellcept), prednisone(steroid)
Page 2/29
, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
Reason why native pancreas left in place during pancreas tx - Answer✔✔-Allows the exocrine
function of native pancreas to be preserved.
Enteric Drainage( ED) post pancreas transplant - Answer✔✔-More common, difficult to detect
rejection, donor portal vein anastomosed to recipients SMV(superior mesenteric vein), donor
duodenal segment attached to recipients jejunum, pancreases produces 2L of fluid drainage,
pancreatic enzymes excreted thru the stool
Advantages of Enteric drain (ED) post pancreas transplant - Answer✔✔-More physiologic, fewer
metabolic imbalances because pancreatic secretions are reabsorbed, less post-op complications
Bladder Drainage (BD) post pancreas transplant - Answer✔✔-Easier to monitor for rejection
with urine amylase, may cause dehydration and cystitis. Direct monitoring of graft exocrine
function, easier to perform biopsy, less invasive if complications arise.
Disadvantages of Bladder Drainage (BD) post pancreas transplant - Answer✔✔-Dehydration,
cystitis, UTIs, metabolic acidosis, urine leak, hematuria, 35% go on to need enteric conversion,
pancreatitis
Patients with anastomotic leak post pancreas transplant may present with what? - Answer✔✔-
Elevated serum amylase levels
C-peptide normal range - Answer✔✔-0.8-3.1
What is a sign of late rejection post pancreas transplant? - Answer✔✔-Hyperglycemia
Page 3/29
CCTC review Study Guide with
Complete Solutions
Procedure for liver transplant - Answer✔✔-Anastomosis of the inferior vena cava, portal vein,
hepatic artery, and the biliary connection via a duct to duct anastomosis (
choledochocholeclochostomy)
Etiology of renal dysfunction immediately post op(liver tx) - Answer✔✔-Hypotensive episodes,
blood loss, high renal vein pressure intraoperatively and postoperatively due to
hemodynamically instability or sepsis.
Leading cause of non graft related death for liver recipients - Answer✔✔-Cardiorespiratory
failure
Which immunosuppressants cause HTN - Answer✔✔-Calcineurin inhibitors or corticosteroids
Which lab to monitor with fever post tx - Answer✔✔-Crp- c reactive protein because protein
present with acute inflammation and sepsis
Indicative of rejection - Answer✔✔-Light stools and dark urine,
Indicative of poor graft function s/p liver transplant - Answer✔✔-High lactate and acidosis, high
ALT/AST, PT >25 sec and continues to rise after vit k and FFP
Page 1/29
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
type 2 diabetes - Answer✔✔-More common, occurs in adulthood, characterized by insulin
resistance. As resistance rise, beta cells are eventually unable to produce necessary amount of
insulin to lower and maintain normal blood glucose levels.
type 1 diabetes mellitus - Answer✔✔-diabetes in which no beta-cell production of insulin occurs
and the patient is dependent on insulin for survival
Goal of pancreas transplant - Answer✔✔-To restore normoglycemia, halt or prevent secondary
complications of diabetes
Indications for pancreas transplant alone (PTA) or pancreas after kidney (PAK) transplant -
Answer✔✔-Type 1 DM manifested by poor metabolic control, especially hypoglycemic
unawareness for many years. On insulin and C-peptide at or < 2 ng/ml or on insulin and C-
peptide at or greater than 2ng/mg and BMI at or less than maximum allowable BMI (currently
28) and pancreatic exocrine insufficiency.
Indications for Simultaneous pancreas-kidney (SPK) transplant - Answer✔✔-Diagnosis of
diabetes or pancreatic exocrine insufficiency with renal insufficiency
Immunosuppressive medications are covered by which part of Medicare? - Answer✔✔-
Medicare part B
Standard immunosuppressive for pancreas transplant recipients typically includes: -
Answer✔✔-Tacrolimus(prograf, FK506), mycophenolate mofetil (cellcept), prednisone(steroid)
Page 2/29
, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
Reason why native pancreas left in place during pancreas tx - Answer✔✔-Allows the exocrine
function of native pancreas to be preserved.
Enteric Drainage( ED) post pancreas transplant - Answer✔✔-More common, difficult to detect
rejection, donor portal vein anastomosed to recipients SMV(superior mesenteric vein), donor
duodenal segment attached to recipients jejunum, pancreases produces 2L of fluid drainage,
pancreatic enzymes excreted thru the stool
Advantages of Enteric drain (ED) post pancreas transplant - Answer✔✔-More physiologic, fewer
metabolic imbalances because pancreatic secretions are reabsorbed, less post-op complications
Bladder Drainage (BD) post pancreas transplant - Answer✔✔-Easier to monitor for rejection
with urine amylase, may cause dehydration and cystitis. Direct monitoring of graft exocrine
function, easier to perform biopsy, less invasive if complications arise.
Disadvantages of Bladder Drainage (BD) post pancreas transplant - Answer✔✔-Dehydration,
cystitis, UTIs, metabolic acidosis, urine leak, hematuria, 35% go on to need enteric conversion,
pancreatitis
Patients with anastomotic leak post pancreas transplant may present with what? - Answer✔✔-
Elevated serum amylase levels
C-peptide normal range - Answer✔✔-0.8-3.1
What is a sign of late rejection post pancreas transplant? - Answer✔✔-Hyperglycemia
Page 3/29
