Fellowship in Anesthesia for Abdominal Organ Transplantation
Broad Academic Experience, Specific Focus On Transplant Anesthesia
The Washington University Fellowship in Anesthesiology for Abdominal Organ Transplantation offers a non-ACGME accredited position at one of the top transplant centers in the U.S. The one-year Fellowship offers comprehensive training in perioperative care of adult patients undergoing abdominal organ transplant, with added experience in complex hepatobiliary, vascular and cardiothoracic surgery.
Washington University School of Medicine and its affiliated hospital, Barnes-Jewish Hospital, are high-volume transplant centers and internationally recognized leaders in organ transplantation. Both institutions provide an exceptional environment for training in basic and clinical sciences and have a strong strategic commitment towards advancing organ transplant program. In 2018, Barnes-Jewish Hospital Transplant Center was the 12th largest solid organ transplant center in the United States, according to data released by the United Network for Organ Sharing. Our first combined heart-liver transplantation was performed in 2011. Also, we have performed three combined liver-lung transplants at our institution. In 2018, we performed 368 solid organ transplants, including:
- 114 Liver Transplantations
- 241 Kidney Transplantations
- 13 Pancreas Transplantations
Clinical & Academic Leadership In Transplant Anesthesiology
The main goal of the Fellowship is to help fellows become clinical experts in perioperative care of abdominal organ recipients and academic leaders in transplant anesthesiology. Our multi-faceted approach to education transforms trainees into expert consultants.
The Clinical Experience – The OR and Beyond
Trainees are exposed to every aspect of care of the liver transplant recipient – from evaluating candidate’s acceptability for transplant to postoperative management in the ICU. The focus of the Fellowship is the intraoperative anesthetic management of transplant recipients. Comprehensive clinical training with structured teaching in thromboelastometry, novel hemodynamic monitoring modalities, and transesophageal echocardiography enriches the clinical experience. Trainees become familiar with the implications of the various surgical techniques employed, including veno-venous bypass and the piggyback technique.
Under supervision, fellows serve as consultants to evaluate potential liver transplant recipients. Fellows attend weekly Multidisciplinary Listing Meetings to discuss the suitability of candidates as well as participate in weekly multidisciplinary Morbidity and Mortality Liver Transplant Conferences to optimize patient care.
Fellowship experience is rounded by rotations in a state-of-the art surgical intensive care unit, blood bank, and on transplant surgery service. Additional rotations can be organized based on the trainee’s interests.
The transplant group shares operating rooms and is fully clinically and educationally integrated with the cardiothoracic anesthesia group. This dynamic allows for Fellows to learn transesophageal echocardiography from experts in the field and become eligible for certification in Basic Perioperative Echocardiography.
Below is an example of an intraoperative TEE, demonstrating a positive bubble study in a patient with hepatopulmonary syndrome.
The Curriculum – Learning From Clinical Leaders
The didactic curriculum and clinical training are under the care of a multidisciplinary team of physicians, including anesthesiologists, intensivists, transplant surgeons, hematologists and hepatologists. Conferences includes the following:
- Abdominal Organ Transplant Lecture Series. Monthly, multi-disciplinary conference with lectures that reinforce fundamentals and provide insight into the current issues in transplantation.
- Transplant Anesthesia Journal Club. Conference dedicated to transplant anesthesia.
- Echocardiography Conference. Weekly conference (OR schedule permitting) lead by cardiothoracic anesthesiologist.
- Hepatobiliary, Transplant, Vascular and Cardiothoracic Anesthesia Conference. Weekly subspecialty conference.
Research – Developing a Greater Understanding
Fellows have protected time for research throughout the year and are encouraged to take advantage of numerous research opportunities available either within the Department of Anesthesiology or in collaboration with other departments in the Medical Center.
Fellowship experience will be tailored to individual candidate’s needs and goals. We encourage interested, board-eligible applicants to contact us and discuss their specific career goals.