Transplant Pre-Treatment FBC — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementTransplant Pre-Treatment FBCORE Part 1

A patient who has received a solid-organ transplant takes ciclosporin, mycophenolate mofetil and prednisolone. They require a dental extraction. Which pre-treatment investigation is MOST important?

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Correct answer: B — Full blood count

A full blood count is most important because mycophenolate mofetil can cause cytopenias, including leukopenia/neutropenia and thrombocytopenia. Before an extraction, the white-cell and neutrophil counts inform infection risk, while the platelet count helps assess bleeding risk. The UK SmPC specifically requires complete blood-count monitoring in patients taking mycophenolate and identifies cytopenias as risks contributing to infection and haemorrhage. Liver function tests may be relevant to the wider medical assessment but do not establish neutrophil or platelet status. An ECG and chest radiograph are only indicated by relevant cardiovascular or respiratory symptoms/history. A ciclosporin concentration is used by the transplant team for therapeutic drug monitoring, not to assess immediate dental procedural bleeding or infection risk.

Reference: Electronic Medicines Compendium. Mycophenolate Mofetil 500 mg film-coated tablets: Summary of Product Characteristics, sections 4.4 and 4.8, updated June 2026. https://www.medicines.org.uk/emc/product/101918/smpc