Abdominal Transplant Surgery Fellowship

 

Pre-renal transplant patients are worked up by nephrologists on the medical staff. These cases are presented at the weekly kidney transplant selection committee for approval. The committee consists of transplant surgeons, nephrologists, social workers, transplant coordinators and other consultants.

After the kidney transplant, the recipient is under the primary care of the transplant surgical team.

Fellows participate in:

Higher-level management of complex medical problems is handled by medical specialists. Fellows and the attending physician work closely with the specialists to support a quality outcome for the kidney transplant recipient.

Fellows' surgical responsibilities for kidney transplantation include:

Living donor renal transplantation makes up nearly a quarter of the kidney transplants performed at Baylor Dallas. Fellows participate in the living donor nephrectomy. The donor nephrectomies are performed laparoscopically and robotically by attending physicians on our transplant team.

The living donor recipient operation is performed by a transplant surgeon and fellow.

Candidates for liver transplantation are evaluated by hepatology physicians on the medical staff at Baylor Dallas along with the fellows. Cases are discussed at the weekly meetings of the liver transplant selection committee, which consists of transplant surgeons, hepatologists, and other specialists on the hospital’s medical staff, along with social workers and transplant coordinators. Once a candidate is approved for transplant, the patient is listed according to United Network for Organ Sharing (UNOS) guidelines.

Fellows participate in the admission and workup of patients at the time of surgery. After transplant, Fellows continue to care for the post-liver transplant recipient in all aspects of his/her medical and surgical needs.

Surgical responsibilities include:

• Completion of a liver transplant
• Completion of number of liver transplants to achieve ASTS certification for liver transplant (45 cases)
• Pre- and post-transplant ICU medical and surgical management
• Participation in both living and deceased liver harvests
• Diagnosis and management of surgical complications (nontransplant related) after liver transplant
• Diagnosis and management of surgical complications after living donor hepatic lobectomy

Intensive Care Unit

Intensive care unit management of the liver transplant patient is intense and complex. Fellows take an active part in the management of the patient’s care, including:

Inpatient Care

Inpatient liver transplant care also is provided by fellows, who are involved in all patient care until discharge. The basics of inpatient management include:

Outpatient Care

Fellows also see patients in the outpatient clinic. Patients may require readmission for infection, rejection or observation. Transplant patients are seen annually after transplant. Fellows learn to perform bedside liver biopsies and interpret results of the follow-up studies.

Fellows participate in and learn about donor and recipient selection for pancreas transplantation. The patient will either receive simultaneous kidney-pancreas transplant, pancreas after kidney transplant or pancreas alone transplant. Fellows acquire various techniques of pancreas implantation and learn to manage these patients post-transplant.

Deceased donor harvests are completed by fellows and a supervising transplant surgeon. Fellows are expected to become the primary surgeon on the organ and tissue procurement and preservation team. Livers, kidneys and pancreases are the principal organs harvested.

Fellows gain experience in: