Education & Training

Clinical Components

The fellow will be responsible for the care of the patients with end-stage organ disease (ESRD) as well as transplant patients; pre and post-transplant. The fellow will also actively participate in outpatient clinic activities, with designated time for kidney transplant evaluation clinic, annual evaluations as well as elective/urgent surgery on patients with end-stage organ disease. The fellow will gain experience in dialysis access procedures (peritoneal and hemodialysis access) in patients with chronic kidney disease and ESRD. The fellow will attend organ-specific multi-disciplinary selection committees and tumor boards.

The goal will be for the fellow to have at least 8 months training in procurement and living donor nephrectomy, 8 months training in kidney transplantation, and 8 months training in liver transplantation. The training will begin with procurement/living donor nephrectomy and progress to kidney and then liver. The fellow will participate and gain proficiency in dialysis access procedures. During the second year of fellowship, the fellow will be expected to be able to guide and assist general surgery residents in these procedures.

Transplant Service

The transplant surgery team interacts with supporting discipline on a daily basis. The fellow will also interact with these disciplines during regularly scheduled meetings and whenever patient care mandates.

• Daily: multidisciplinary rounds with nephrology on the kidney service
• Daily (Mon-Fri): multiple disciplinary rounds on a liver service with hepatology (attending and fellow), social work, liver coordinator, nutrition, NP/PA, surgery residents in surgeon on service
• Weekly: liver tumor board which includes surgery, hepatology, radiology, oncology, pathology, interventional radiology and radiology or radiation oncology

Research

The program has an active basic science research laboratory held by Dr. Kenneth Chavin, MD, PhD. Participation in research will be strongly encouraged. The fellow will have the opportunity to participate in this laboratory and formulate their own research project under the guidance of one of the attendings. It is our goal to have the fellow push at least one article in a peer-reviewed Journal within the two years he/she has been a fellow at our institution.

Conferences and Training

We are working with our HLA lab to develop a two-year lecture series on histocompatibility and tissue typing/ transplant immunology. Fellows will get histopathology training during the tumor board conference where the pathologists are present to review tumor and expert’s slides. In addition, the pathologists meet with the surgeon impromptu to review pathology on current patients.

• Teaching conference (Fridays): There is an hour-long teaching conference to discuss current inpatients which includes discussion around immunosuppression, rejection treatment histopathology, transplant immunology, etc.
• Monthly transplant Journal club: The Journal club is an hour long discussion about current literature where several articles will be chosen or presented. The fellow will be expected to present at this Journal club at least twice a year.
• Visiting lecture series: The transplant Institute will also have visiting professor lecture series, which the fellow will be expected to attend.
• Morbidity and Mortality conference: The fellow will also attend the general surgery department Morbidity and Mortality conference
• Grand Rounds