Exam 4 (Organ Procurement & Transplant:
Lecture Notes), 178 Questions And Correct
Answers, With Complete Solution 2024.
A single donor can provide up to ____ life-saving organs
8
Can you name the four most commonly transplanted organs? (start the list with
the most common)
1. kidneys
2. liver
3. heart
4. lung
What is a VCA/CTA? What does this stand for?
VCA = vascular composite allograft
CTA = composite tissue allograft
these are the same thing, basically mean (any) two or more tissues are combined for
grafting
What was the goal of the Southeastern Organ Procurement Foundation? What is
it now?
enhance access → computer-based organ sharing
today: American Foundation for Donation of Transplantation
The development of what medication was a game changer for organ transplant
success?
cyclosporin
When was cyclosporin discovered/developed?
1974
What is cyclosporin used for? Drug class?
immunosuppressant drug used to treat organ rejection post-transplant
calcineurin inhibitor
What is a negative side effect of calcineurin inhibitors?
increases the risk of infection and malignancy d/t its immunosuppressive actions
What are the 4 components of the National Organ Transplant Act?
1. made it illegal to buy or sell organs
2. established Organ Procurement Transplant Network (OPTN)
3. established United Network for Organ Transplant (UNOS)
4. created a scientific registry of transplant recipients
What is UNOS?
,Non-profit, charitable organization that serves as the nation's coordinator of organ
procurement and allotment under contract with the US government
What is the name of the organization that manages the nation's transplant waiting
list and maintains the DONORNET database? When was it established?
UNOS
1984
How many folks are currently awaiting organs (on the transplant list)?
What is the most often transplanted organ?
104,068
kidney
Name the 4 sources of organ donation
1. brain dead donor
2. donation after cardiac death
3. marginal donors
4. living donors
What is the most common and most ideal source of organs?
brain dead donor
Donation after cardiac death: what is the definition of death for these patients?
What are the requirements of these donors to allow them to donate organs?
cessation of circulation and respiration
death must occur within 2 hours s/p removal of life support and then must remain dead
for 2 minutes before the organs can be harvested
The decision to withdraw care from a patient who is NOT brain dead has to be a
________________ decision, made _____________ the organ donation
conversation
the decision to withdraw care from a patient who is NOT brain dead has to be
a completely separate decision, made before the organ donation conversation
What are marginal donors? Can you name an example?
donor organs that have an increased risk of primary graft dysfunction
examples:
-donation after cardiac death
-older donor patient
(ie not an ideal organ, but one that can still be transplanted)
What are the advantages of a living donor? (2)
1. healthy donors with a known medical history
2. less cold ischemic time (usually in two ORs next to each other)
are marginal donors and organ donors a part of the same list?
no, marginal donors comprise a separate "alternate" transplant list
It is important to maintain euvolemia in organ transplant patients (especially
lungs). What are the CVP/PCWP values you're aiming to maintain?
, CVP 6-12
PCWP <12
Of our standard medications (versed, fentanyl, NMBDs), which will you expect to
use in organ procurement surgery? Why?
only NMBDs
brain dead patients may still have intact spinal reflexes that you need to block
What is the order of organ procurement?
1a. Face (if taking)
1b. Heart
2. Lung
3. Liver
4. Pancreas
5. Small intestine
6. Kidney
During organ procurement, what are the organs perfused with?
hyper-osmotic, hyperkalemic solution,
containing insulin, glucose and reducing agents
when does the "ischemic time" clock start ticking?
once organs have been flushed with the hyperosmotic, hyperkalemic solution
During organ procurement, when is anesthesia's job typically done? Explain what
that means
anesthesia's job is typically over s/p organ flush
gtts are stopped and ventilator is turned off
What are the maximum cold ischemic times for the following organs?
Heart:
Lung:
Liver:
intestines:
pancreas:
Kidney:
cornea:
tissue:
Heart: 4-6 hrs
Lung: 4-6 hrs
Liver: 8-12 hrs
intestines: 8-16 hrs
pancreas: 12-18 hrs
Lecture Notes), 178 Questions And Correct
Answers, With Complete Solution 2024.
A single donor can provide up to ____ life-saving organs
8
Can you name the four most commonly transplanted organs? (start the list with
the most common)
1. kidneys
2. liver
3. heart
4. lung
What is a VCA/CTA? What does this stand for?
VCA = vascular composite allograft
CTA = composite tissue allograft
these are the same thing, basically mean (any) two or more tissues are combined for
grafting
What was the goal of the Southeastern Organ Procurement Foundation? What is
it now?
enhance access → computer-based organ sharing
today: American Foundation for Donation of Transplantation
The development of what medication was a game changer for organ transplant
success?
cyclosporin
When was cyclosporin discovered/developed?
1974
What is cyclosporin used for? Drug class?
immunosuppressant drug used to treat organ rejection post-transplant
calcineurin inhibitor
What is a negative side effect of calcineurin inhibitors?
increases the risk of infection and malignancy d/t its immunosuppressive actions
What are the 4 components of the National Organ Transplant Act?
1. made it illegal to buy or sell organs
2. established Organ Procurement Transplant Network (OPTN)
3. established United Network for Organ Transplant (UNOS)
4. created a scientific registry of transplant recipients
What is UNOS?
,Non-profit, charitable organization that serves as the nation's coordinator of organ
procurement and allotment under contract with the US government
What is the name of the organization that manages the nation's transplant waiting
list and maintains the DONORNET database? When was it established?
UNOS
1984
How many folks are currently awaiting organs (on the transplant list)?
What is the most often transplanted organ?
104,068
kidney
Name the 4 sources of organ donation
1. brain dead donor
2. donation after cardiac death
3. marginal donors
4. living donors
What is the most common and most ideal source of organs?
brain dead donor
Donation after cardiac death: what is the definition of death for these patients?
What are the requirements of these donors to allow them to donate organs?
cessation of circulation and respiration
death must occur within 2 hours s/p removal of life support and then must remain dead
for 2 minutes before the organs can be harvested
The decision to withdraw care from a patient who is NOT brain dead has to be a
________________ decision, made _____________ the organ donation
conversation
the decision to withdraw care from a patient who is NOT brain dead has to be
a completely separate decision, made before the organ donation conversation
What are marginal donors? Can you name an example?
donor organs that have an increased risk of primary graft dysfunction
examples:
-donation after cardiac death
-older donor patient
(ie not an ideal organ, but one that can still be transplanted)
What are the advantages of a living donor? (2)
1. healthy donors with a known medical history
2. less cold ischemic time (usually in two ORs next to each other)
are marginal donors and organ donors a part of the same list?
no, marginal donors comprise a separate "alternate" transplant list
It is important to maintain euvolemia in organ transplant patients (especially
lungs). What are the CVP/PCWP values you're aiming to maintain?
, CVP 6-12
PCWP <12
Of our standard medications (versed, fentanyl, NMBDs), which will you expect to
use in organ procurement surgery? Why?
only NMBDs
brain dead patients may still have intact spinal reflexes that you need to block
What is the order of organ procurement?
1a. Face (if taking)
1b. Heart
2. Lung
3. Liver
4. Pancreas
5. Small intestine
6. Kidney
During organ procurement, what are the organs perfused with?
hyper-osmotic, hyperkalemic solution,
containing insulin, glucose and reducing agents
when does the "ischemic time" clock start ticking?
once organs have been flushed with the hyperosmotic, hyperkalemic solution
During organ procurement, when is anesthesia's job typically done? Explain what
that means
anesthesia's job is typically over s/p organ flush
gtts are stopped and ventilator is turned off
What are the maximum cold ischemic times for the following organs?
Heart:
Lung:
Liver:
intestines:
pancreas:
Kidney:
cornea:
tissue:
Heart: 4-6 hrs
Lung: 4-6 hrs
Liver: 8-12 hrs
intestines: 8-16 hrs
pancreas: 12-18 hrs
