Training & Curriculum
There is one fellow per year in a two-year fellowship program with kidney, liver and HPB surgery. In the course of two years, fellows will spend 10 months on liver transplant, seven months on kidney transplant and seven months on HPB surgery. As pancreas transplants are relatively infrequent (10-12 cases/year), the senior fellow scrubs all pancreas transplant procurements and transplants. They are involved in the longitudinal care of the transplant patients, starting from pre-transplant evaluation and post-transplant long-term follow-up.
The fellowship provides a monthly lecture series specifically for the transplant fellows. Subject matter includes: liver transplant, kidney transplant, pancreas transplant, nephrology, hepatology, pathology, immunosuppression, organ allocation, etc. Lectures are given by our faculty experts. The fellows also present cases for transplant morbidity and mortality conferences each month along with a monthly journal club for liver and kidney transplantation.
During the liver transplant rotation, the fellow is responsible for ward and ICU management in conjunction with a multidisciplinary team. The liver transplant service manages high-MELD (MELD>30) patients on the service and consults on lower inpatient MELD patients. Fellows procure deceased donor livers independently; there are no living donor liver transplants performed at our center. The second-year fellow scrubs all liver transplants.
The kidney transplant rotation is under the supervision of both transplant surgery and nephrology, as primary patient management is under the transplant nephrology service. Fellows learn desensitization protocols, as this is one of the distinguishing features of the Cedars-Sinai fellowship, by attending monthly Transplant Immunology Program meetings and co-managing pre- and post-transplantation in highly sensitized patients.
Conferences and Programs
Liver transplantation: (regardless if fellows are rotating on this service):
- Transplant selection conference (weekly): Fellows present inpatient liver transplant evaluation patients. Outpatient liver transplant evaluation patients are seen by the fellow but presented by hepatology.
- ASTS fellowship lecture series (monthly): ASTS academic universe curriculum is presented monthly by a rotation of attendings. Fellows are given key literature and are quizzed based on ASTS AU questions.
- Liver transplant journal club (monthly): Fellows, visiting residents and occasional medical students are given current high-impact literature to present on liver transplant-focused topics.
- Optional: The fellows are encouraged to attend weekly liver pathology conference. Cases discussed include inpatient hepatology patients, ex-plant liver pathology and post-transplant biopsy samples.
- Radiology conference (weekly, mandatory): Imaging for inpatient liver transplant evaluation patients and tumor patients is reviewed.
Kidney transplant service: (while fellows rotate on the service):
- Kidney transplant selection (weekly): Fellows attend kidney transplant selection and aid in the presentation of patients they have seen in clinic.
- Transplant immunology conference (twice monthly): On the kidney service, the fellows are encouraged to attend pre-transplant desensitization treatment conferences, which occur twice every month.
- Kidney transplant journal club (weekly): Journal club articles presented by faculty and visiting residents.
Hepatobiliary service: (while fellows rotate on this service):
- Pancreatitis meeting (weekly)
- Neuroendocrine tumor board meeting (weekly)
- Pancreatic tumor board (weekly)