Factors during donor care that may affect liver transplantation outcome

Progress in Transplantation, Sep 2004 by Powner, David J

CE Test Questions

Factors during donor care that may affect liver transplantation outcome

1. Which Statement about the limitations of the database is false?

a. Including only human data usually restricts available information to noninterventional observations.

b. Assumption of causality can be especially inappropriate when analyzing a process as physiologically complex as donor care.

c. A statistical association found between a factor and an outcome proves that the factor alone caused the change.

d. Preoperative or intraoperative factors are likewise nonstandardized and maybe unreported, but they would affect outcomes in unknown ways.

2. Which factors are not amenable to change?

a. Age, macrosteatosis, endotoxin/cytokines

b. Length of stay, sex, ABO type

c. Cause of death, ischemia times, age

d. Hypernatremia, endotoxin and cytokines, macrosteatosis

3. Which liver transplants had 11% better outcome in a review of data from the United Network for Organ Sharing?

a. Female donor to female recipient

b. Donors younger than 45 years old

c. Donor death other than head trauma

d. Fatty liver donors

4. Which liver problem is a strong predictor of poor graft function or survival?

a. Fatty infiltration of the liver

b. Increased level of endotoxins

c. Increased level of cytokines

d. Increased C reactive protein in donor blood

5. What length of time is critical cold ischemia time?

a. 1 to 6 hours

b. 6 to 12 hours

c. 12 to 18 hours

d. 18 to 24 hours

6. What term identifies the time that begins when a liver is secured in place and extends until reperfusion with recipient blood begins?

a. Cold ischemia time

b. Warm injury time

c. Critical ischemia time

d. Warm ischemia time

7. How does hypernatremia affect graft function?

a. Increased graft loss, increased enzyme levels, increased partial thromboplastin time

b. Decreased graft loss, decreased enzyme level, increased prothrombin time

c. Increased graft loss, increased enzyme level, increased prothrombin time

d. Decreased graft loss, increased enzyme level, increased partial thromboplastin time

8. What should be the goal of the sodium level during donor care?

a. Less than 155 mmol/L

b. 140 to 155 mmol/L

c. 135 to 145 mmol/L

d. 135 to 155 mmol/L

9. What term identifies the intracellular molecules intended to balance the osmolarity gradient across liver cell membranes?

a. Osmolarity molecules

b. Intracellular molecules

c. Intracellular osmoles

d. Idiogenic osmoles

10. In the study by Cywes et al, what intervention was done to improve glycogen stores?

a. Peripheral infusion of dextrose 5% and insulin

b. Preoperative administration of dextrose 50% ampules

c. Central infusion of dextrose 20% and insulin

d. Intraoperative infusion of 25% glucose and insulin into the portal vein

11. What risk is involved in glucose "loading"?

a. Decreased osmolarity, ketoacidosis, increased liver enzymes

b. Increased plasma osmolarity, hyperglycemia, increased urine output

c. Increased intracellular osmolarity, decreased liver enzymes, increased urine output

d. Decreased intracellular osmolarity, increased liver enzymes, decreased urine output