CCTC REVIEW EXAM QUESTIONS AND
CORRECT ANSWERS. VERIFIED
2025/2026.
Procedure for liver transplant - ANS 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) - ANS 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 - ANS Cardiorespiratory failure
Which immunosuppressants cause HTN - ANS Calcineurin inhibitors or corticosteroids
Which lab to monitor with fever post tx - ANS Crp- c reactive protein because protein present
with acute inflammation and sepsis
Indicative of rejection - ANS Light stools and dark urine,
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Indicative of poor graft function s/p liver transplant - ANS High lactate and acidosis, high
ALT/AST, PT >25 sec and continues to rise after vit k and FFP
type 2 diabetes - ANS 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 - ANS diabetes in which no beta-cell production of insulin occurs and
the patient is dependent on insulin for survival
Goal of pancreas transplant - ANS To restore normoglycemia, halt or prevent secondary
complications of diabetes
Indications for pancreas transplant alone (PTA) or pancreas after kidney (PAK) transplant -
ANS 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 - ANS Diagnosis of diabetes or
pancreatic exocrine insufficiency with renal insufficiency
Immunosuppressive medications are covered by which part of Medicare? - ANS Medicare
part B
Standard immunosuppressive for pancreas transplant recipients typically includes: -
ANS Tacrolimus(prograf, FK506), mycophenolate mofetil (cellcept), prednisone(steroid)
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Reason why native pancreas left in place during pancreas tx - ANS Allows the exocrine
function of native pancreas to be preserved.
Enteric Drainage( ED) post pancreas transplant - ANS 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 - ANS More physiologic, fewer
metabolic imbalances because pancreatic secretions are reabsorbed, less post-op complications
Bladder Drainage (BD) post pancreas transplant - ANS 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 - ANS 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? -
ANS Elevated serum amylase levels
C-peptide normal range - ANS 0.8-3.1
What is a sign of late rejection post pancreas transplant? - ANS Hyperglycemia
Patients with chronic pancreas rejection can present with what? - ANS Progressive need for
insulin
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
CORRECT ANSWERS. VERIFIED
2025/2026.
Procedure for liver transplant - ANS 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) - ANS 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 - ANS Cardiorespiratory failure
Which immunosuppressants cause HTN - ANS Calcineurin inhibitors or corticosteroids
Which lab to monitor with fever post tx - ANS Crp- c reactive protein because protein present
with acute inflammation and sepsis
Indicative of rejection - ANS Light stools and dark urine,
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Indicative of poor graft function s/p liver transplant - ANS High lactate and acidosis, high
ALT/AST, PT >25 sec and continues to rise after vit k and FFP
type 2 diabetes - ANS 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 - ANS diabetes in which no beta-cell production of insulin occurs and
the patient is dependent on insulin for survival
Goal of pancreas transplant - ANS To restore normoglycemia, halt or prevent secondary
complications of diabetes
Indications for pancreas transplant alone (PTA) or pancreas after kidney (PAK) transplant -
ANS 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 - ANS Diagnosis of diabetes or
pancreatic exocrine insufficiency with renal insufficiency
Immunosuppressive medications are covered by which part of Medicare? - ANS Medicare
part B
Standard immunosuppressive for pancreas transplant recipients typically includes: -
ANS Tacrolimus(prograf, FK506), mycophenolate mofetil (cellcept), prednisone(steroid)
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Reason why native pancreas left in place during pancreas tx - ANS Allows the exocrine
function of native pancreas to be preserved.
Enteric Drainage( ED) post pancreas transplant - ANS 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 - ANS More physiologic, fewer
metabolic imbalances because pancreatic secretions are reabsorbed, less post-op complications
Bladder Drainage (BD) post pancreas transplant - ANS 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 - ANS 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? -
ANS Elevated serum amylase levels
C-peptide normal range - ANS 0.8-3.1
What is a sign of late rejection post pancreas transplant? - ANS Hyperglycemia
Patients with chronic pancreas rejection can present with what? - ANS Progressive need for
insulin
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
