Transplant Fellowship Program
The Transplant Fellowship program is designed to be a two year, non–ACGME approved fellowship for graduates of general surgical residency programs who are Board–eligible or equivalent. The experience will involve the evaluation and management of kidney, pancreas and liver transplant surgery patients, with a focus on operative and non–operative decision making. We will recruit only one fellow for each year for the 2 year multiorgan transplant fellowship program. The Fellow will be involved in the supervision and education of residents.
The transplant program at Yale New Haven Hospital evaluates approximately 1000 patients per annum, and transplants approximately 100 kidney, 50 liver and 5 pancreas patients a year. Additionally, the transplant team procures approximately 60 abdominal organs per year. Moreover, the transplant surgery team performs 100 hepatobiliary surgery cases and 150 vascular access procedures per year.
Yale New Haven Transplantation Center (YNHTC) Multiorgan Transplantation Fellowship Program is a newly established entity. The program will provide Liver, Kidney, Pancreas Transplantation training. All abdominal organ transplantation procedures including liver, kidney, pancreas transplantations, at the YNHTC are performed by members of the Section of Transplantation and Immunology in the Department of Surgery. Similarly, the majority of dialysis access procedures, and general surgical procedures on the ESRD and ESLD population are performed by members of this Section.
Clinical and laboratory responsibility of the Trainee:
During the 2 year clinical transplant fellowship, the trainee will assume primary responsibility in a graded manner for all aspects of living donor and cadaver renal transplantation, as well as in pancreatic transplantation. Trainee will also perform/participate and take responsibility for living donor and cadaver liver transplant procedures as well as hepatobiliary surgeries including major liver resections, shunt surgeries in both adult and pediatric patient population. The trainee will additionally rotate through the Histocompatibility and Immune Evaluation Laboratory for the purpose of exposure to tissue typing and monitoring techniques. Section of Transplantation and Immunology at Yale has its own tissue typing laboratory. This will facilitate rotation and education of fellows.
Finally, the trainee will be expected to provide evidence of scholarly development as evidenced by an independent research project, usually as a component a chosen aspect of the ongoing investigative work in the Section. It is anticipated that for most this will represent a clinical project but ample opportunity exists for more intensive bench research within the Section Laboratories and/or through our close collaborators in the Yale Interdisciplinary Research Program in Vascular Biology and Transplantation.
Transplant and Immunology Conferences at Yale
The Section of Transplantation and Immunology holds several conferences each week, dedicated specifically to problems relevant to the transplant setting:
The Recipient Review Committee for Kidney/Pancreas Transplantation meets each Monday morning; this is a working conference designed to serve as a final review conference where prospective transplant recipients are presented prior to placing appropriate candidates on the active transplant waiting list. The Recipient Review Committee for Liver Transplantation meets every Wednesday afternoon that is also designed to serve as a final review conference where prospective transplant recipients are presented prior to placing appropriate candidates on the active liver transplant waiting list.
Our weekly Journal Club Meetings are held every Monday afternoon. In this conference, selected papers are presented by our fellows, residents and faculty members.
Our weekly M&M and Difficult Case Presentation Conferences for all programs are held every Thursday afternoon. In this conference, all morbidity and mortalities as well as difficult pre and post transplant patient management issues are discussed. For M&M part, minutes are hold and reported to Yale New Haven Transplantation Center QA/PI Committee Chair.
Our weekly Resident/Fellow Teaching Conferences are held every Tuesday morning. In this didactic teaching event, Yale faculty will give lectures about transplant related topics including immunology, immunosuppressive medications, medical and surgical aspects of liver, kidney and pancreas transplantations, pathology, infectious disease, cardiac and neurological problems related to transplantation.
Yale New Haven Transplantation Center Grand Rounds are held every Thursday afternoon. Nationally and internationally known experts in the fields of transplantation and immunology are invited to give lectures to our fellows, residents and faculty.
Additionally, the Section of Immunology in the School of Allergy and Immunology in the Department of Medicine holds a weekly clinical immunology conference, and there are many additional relevant conferences and seminars held regularly throughout the Medical School.
Training in histopathology and interpretation of allograft biopsies
It is the usual practice to physically review all allograft biopsies when they are performed. The Yale–New Haven Transplantation Center is privileged to have excellent collaborative working relationships with Department of Pathology and its members in kidney and liver pathology. Additionally, there are monthly renal pathology and liver pathology histology review conferences where transplant histopathology as well as renal and liver pathology are reviewed in a didactic setting. Through these activities, each transplant fellow is expected to master the histopathological interpretation of renal and liver allograft biopsies during the course of the 2 year clinical fellowship.
Histocompatibility, tissue typing and transplant immunology
As outlined above, each fellow will rotate in the histocompatibility and immune evaluation laboratory. That experience, coupled with the ongoing clinical interactions consequent to the care of the transplant patients will provide the fellow with ample opportunities to master these important areas.