Transplant Surgery Service
The Division of Transplantation Surgery is very diverse in its clinical activities. The Division includes the sections of Liver Transplantation and Kidney-Pancreas Transplantation, along with intestine, multivisceral, kidney and hepatobiliary surgery. General Surgery residents rotate on the service during their second and fifth years of training. Since one to three residents from other departments are assigned to our service at any given time, we maintain a call schedule that averages every third or fourth night, with each resident expected to have one in three weekends free from patient care responsibilities. A transplant coordinator is available to assist you with the daily processes of discharge planning and patient specific care issues.
Ours is very busy patient care service, complemented by a robust operating schedule. Second year residents generally experience their first concentrated opportunity to perform vascular anastomoses, through both operations for hemodialysis, and kidney transplantation. Through participation in renal transplantation operations, they also acquire a fundamental understanding of retroperitoneal exposure during renal transplantation. Knowledge gained through this anatomic dissection will be embellished by that gleaned through the many organ procurement operations in which all residents on service will be given the opportunity to participate.
The fifth year resident is expected to assume senior level responsibilities in regards to managing the Transplantation service. In addition to conducting a large number of access procedures, this resident will perform many of the living donor renal transplants, and some cadaver donor transplants. In addition, the fifth year resident can expect to fill the role of first assistant on the liver transplant procedures. A senior resident assigned to one of the General Surgery services is designated to work with the Transplantation service on the major hepatic resections, porto-systemic shunts and on some of the donor liver procurement procedures.
Clinically, the residents are expected to learn the pathophysiology of end-stage kidney disease and end-stage liver disease. We believe the patients cared for on our service provide the residents with a unique experience that not available on any other rotation. Clearly, a basic understanding of transplant immunosuppression and its complications thereof will be achieved. Detailed bedside rounds with senior staff members and a dedicated transplant pharmacist, coupled with key didactic sessions further support the learning environment. We provide a “hands-on” transplant manual to all of our residents while participating on our service. Generally, residents completing their rotation at the third year level mature clinically and technically and speak very highly of the rotation as a very unique experience for their level.