Transplant Rotation (1

st
year)
Length of Rotation: 4 weeks
Type of Rotation: mandatory
Overview:
Each fellow will participate in an intensive transplant rotation for one month in the 1
st
year and one month
in the 2
nd
year of training. The fellow will become eperienced in the management of transplant patients
in the o!tpatient settings. The fellow will be s!pervised in the management of preoperative eval!ation"
perioperative care and ac!te and chronic post#transplant management.
Principle Teaching/Learning Activities:
$ (ATC) Acute Transplant Clinic: %ellows will attend ac!te transplant clinic in the &oye &edical ''
(!ilding. They will be involved in the management of imm!nos!ppression and medical management
of their contin!ity transplant patients.
$ (CTC) Chronic Transplant Clinic: %ellows will attend chronic transplant clinic at E)*
+ephrology. They will see 2#, patients each clinic and be s!pervised directly by a transplant
attending.
$ (TRE) Transplant Recipient Evaluation: %ellows will perform o!tpatient transplant recipient
eval!ations d!ring this rotation. They will be s!pervised by the office or transplant attending for
o!tpatient eval!ations. 'n addition" fellows will attend at least one family conference and social
worker eval!ation at the E)* Transplant )linic in &oye &edical ''.
$ (TR) npatient Transplant Roun!s: %ellows on this rotation will not be responsible for inpatient
transplant patients. -c!te transplant recipients will be eval!ated by the )ons!lt %ellow !nder the
s!pervision of the )ons!lt -ttending .with or witho!t the assistance of the Transplant -ttending" at
the discretion of both the )ons!lt %ellow and/or )ons!lt -ttending0. )hronic transplant patients will
be eval!ated by the 1ervice fellow !nder the s!pervision of the 1ervice -ttending .with or witho!t the
assistance of the Transplant -ttending" at the discretion of both the 1ervice %ellow and/or 1ervice
-ttending0.
$ (T"E) Transplant "onor Evaluation: %ellows will attend o!tpatient transplant donor eval!ations at
&oye &edical '' d!ring this rotation. They will be directly s!pervised by an E)* +ephrology
Transplant attending or an Eastern +ephrology attending who is eperienced in donor eval!ation.
$ (#LA) #LA la$: %ellows will spend 1#2 ho!rs with Lorita Rebellato" 2h3 reviewing 4L-
methodology and techni5!es.
$ (L) Lectures: %ellows will attend 6 core transplant lect!res d!ring the month.
$ (T%) Transplant %eetings: %ellows will attend the monthly transplant b!siness meeting" recipient
selection committee meeting" and donor selection committee meeting.
$ (T&) Transplant &urgeries: Each fellow will attend as many sched!led living donor transplant
s!rgeries as possible. The fellows will complete training in proper sterile techni5!e so they can scr!b
in on transplant s!rgeries. Each fellow is responsible for participating in one deceased donor
transplant s!rgery.
$ (A&) Access &urgeries: %ellows will also !tili7e this month as an opport!nity to scr!b in on as many
access s!rgeries as possible.
$ (#"R) #e'o!ialysis Roun!s: %ellows will ro!nd independently once d!ring the month on their
o!tpatient hemodialysis shift and once d!ring the month with the hemodialysis shift teaching
attending.
$ (RL) Rea!ing List: Reading list as o!tlined at the bottom of this page. 1pecifically refer to the
8E)* Transplant &an!al9 provided at the beginning of the rotation.
Principle E!ucational (oals $y Relevant Co'petency
'n the tables below" the principle ed!cational goals for the +ephrology Transplant Rotation are listed for
each of the si -):&E competencies. The second col!mn of the table indicates the most relevant
principle teaching/learning activity for each goal" !sing the legend above.

1) Patient Care
Principle E!ucational (oals Learning Activity
Lear now to eval!ate and select transplant candidates. TRE" RL" T&
Learn how to cond!ct preoperative eval!ation and preparation of
transplant recipients and donors.
TRE" 4L-" T&
;bserve living and deceased donor transplant s!rgeries. T1
<ith attending assistance" learn the immediate postoperative
management of transplant recipients.
T1" -T)" T&
(ecome familiar with the administration imm!nos!ppressive
medications.
T1" -T)" )T)" T&" L
(ecome familiar with the medical management of transplant re=ection in
patients.
-T)" )T)" T&" L
2rovide long#term management of transplant recipients in the
amb!latory setting.
)T)
;bserve vasc!lar access s!rgeries !tili7ed in the maintenance of chronic
vasc!lar access patency.
-1
)) %e!ical *nowle!ge
Principle E!ucational (oals Learning Activity
(ecome familiar with the basic principles of imm!nology. L" 4L-
(egin to !nderstand the biology of transplant re=ection. L" 4L-
Learn the indications and contraindications to renal transplantation. TRE" L
(ecome familiar with the principles of transplant recipient eval!ation
and selection.
TRE" RL
(ecome familiar with the principles of transplant donor eval!ation and
selection .both deceased donor and living donor0.
T3E" RL
(ecome aware of the principles of organ harvesting" preservation" and
sharing.
L
3escribe the pathogenesis and management of ac!te renal fail!re in the
transplant setting.
-T)" )T)" L" RL
(ecome familiar with the infectio!s complications of transplantation. -T)" )T)" L" RL
+) Practice,-ase! Learning an! 'prove'ent
Principle E!ucational (oals Learning Activity
(ecome familiar with the peri#transplant process. TRE" -T)" )T)
*sing yo!r transplant notebook as a reference" review c!rrent g!idelines
pertaining to the care of the transplant recipient.
-T)" RL
Review yo!r o!tpatient hemodialysis shift to ens!re that appropriate
referral for transplantation has occ!rred.
43R
.) nterpersonal &/ills an! Co''unication
Principle E!ucational (oals Learning Activity
2articipate in disc!ssions with patients and their families as they are
ed!cated abo!t transplantation.
TRE
)omm!nicate effectively with physician colleag!es" n!rsing and other
staff to ass!re timely" comprehensive patient care.
TRE" -T)" T&
)omm!nicate effectively with fellow colleag!es when signing o!t
patients or following post#transplant patients who wo!ld normally be
seen by the cons!lt fellow.
TRE" -T)
)omm!nicate effectively with the cons!lt attending while managing
patients hospitali7ed on the transplant service.
-T)
0) Pro1essionalis'
Principle E!ucational (oals Learning Activity
2rofessional cond!ct toward patients" families" colleag!es" transplant
coordinators and staff" floor n!rses and staff and all other members of
the health care team is epected.
-ll
2rovide individ!ali7ed care of both donors and recipients that provides
the best possible care independent of the impact this may have on the
patient>s respective donor or recipient.
T3E" TRE
2) &yste's,-ase! Practice
Principle E!ucational (oals Learning Activity
3evelop !nderstanding of the m!ltidisciplinary reso!rces necessary to
provide optimal care to the transplant patient: transplant s!rgeon"
transplant n!rsing coordinator" transplant administrative staff" transplant
social worker" pharmacist" inpatient n!rsing staff" referring nephrologist.
TRE" T3E" -T)" )T)" T&" T1
)ollaborate with other members of the transplant team to ins!re
comprehensive care for patients who are !ndergoing or have received a
kidney transplant.
TRE" T3E" -T)" )T)" T&" T1
Reco''en!e! Resources:
# The fellow will be given a packet of rea!ing 'aterial that incl!des articles/hando!ts
on: imm!nology" imm!nos!ppression" donor eval!ation" recipient eval!ation"
preoperative cardiac clearance and g!idelines on the longterm management of renal
transplant recipients.
# ;ther !sef!l internet reso!rces incl!de:
http://www.!nos.org/
http://www.!stransplant.org/inde.php
http://www.optn.org
http://www.a#s#t.org/
http://www.transplantation#soc.org/
Evaluation %etho!s:
%ellows are formally eval!ated by the E)* Transplant -ttending.s0 !sing the standard competency#based
-('& eval!ation form on +ew 'nnovations. This eval!ation will be disc!ssed with the fellow face#to#
face at the end of the rotation.
Approve! $y (overning -o!y 3/4/536 0/3/15
Revised 03/15/11; 9/3/14