The Transplant nephrology fellow will spend a total of 6 months on the inpatient service and 6 months in the outpatient setting. The inpatient service is a combined medical-surgical team in which the transplant fellow provides are for new transplant recipients in addition to patients admitted for post-transplant complications. Outpatient months include living donor and recipient evaluations, with two months protected for research. During these research months, the fellow works on a project of their interest under the direction of either transplant nephrologists, surgeons, or the HLA lab personnel, Didactic sessions include a lecture series with transplant dedicated lectures 1-2 times
a month, transplant journal club in conjunction with our transplant surgery team monthly, weekly review of pathology with transplant pathologists, nephrologists, and surgeons, weekly grand rounds, and a structured HLA course. Please refer to below for our weekly educational schedules, annual clinical schedule, and weekly clinical schedule. The fellow is expected to attend three outpatient clinics per week while on both inpatient and outpatient months to ensure the best opportunity for continuity of care. The fellow is protected from clinical duties during the weekly core curriculum, grand rounds, and monthly journal club. EDUCATIONAL SCHEDULE: Monday - Renal
Transplant Pathology Conference, Tuesday - Department of Internal Medicine Grand Rounds at Houston Methodist Hospital, Wednesday - Baylor College of Medicine/Houston Methodist Renal Grand Rounds. 1X Monthly Transplant Surgery Grand Rounds, Thursday -General Nephrology and Transplant Nephrology Core Curriculum. CLINICAL SCHEDULE: The following is the 12 month schedule of Transplant Nephrology: 1 - HLF Lab, 2 - Transplant Outpatient and Kidney Donor Evaluation, 3 - Infectious Diseases/Elective, 4 - Inpatient, 5 - Inpatient, 6 - Inpatient, 7 - Inpatient, 8 - Inpatient, 9 - Inpatient, 10 - Research, 11 - Renal Pathology, 12 - Research.
CLINICS AND ROUNDS: Monday - Transplant Clinic. Manage immediate post-transplant kidney and kidney pancreas recipients on a weekly to monthly basis and long-term transplant recipients on an annual basis in conjunction with transplant surgery and other ancillary staff. Thursday - Transplant Nephrology Clinic. The transplant nephrology fellow works alongside transplant nephrologists in managing immediate post-transplant kidney recipients, but principally in the care of long-term kidney and kidney pancreas transplant recipients. He or she is an integral part of developing comprehensive care protocols involving cardiovascular, mineral bone disease, and malignancy screening and treatment. In the event of allograft rejection, the transplant nephrology fellow collaborates with the transplant nephrologists and pharmacists to devise a treatment plan. Friday - Immediate Post-transplant Follow-up Clinic. This clinic provides the transplant nephrology fellow the opportunity to provide comprehensive clinical management of the immediate post-transplant patients. He or she primarily manages the patients under the supervision of AST certified nephrologists. RESOURCES USED: Textbooks: A) Handbook of Kidney Transplantation - 6th edition, Dr. Gabriel Danovitch, Wolters Kluwer 2017 B) The Living Donor Transplantation - Edited by Henkie P. Tan, Amadeo Marcos, Ron Shapiro, Informa Healthcare 2007 - AST Comprehensive Trainee Curriculum - A) Renal 1. Evaluation of Recipient Candidacy for Renal Transplantation, 2. Deceased Donor Kidney Allocation in the US, 3. Induction and Maintenance Immunosuppression in Renal Transplantation, 4. Overview of Rejection: Diagnosis, Pathology, Management and Outcomes, 5. Renal Graft Pathology, B) Basic Immunology, 1. Clinical Assays of Immune Function and Transplantations, 2. Histocompatibility Techniques and Risk Assessment before and after Transplantation, C) Pharmacology, 1. Induction/Rejection Therapy (Immunosuppression pharmacokinetics and drug therapy monitoring), 2. Immunosuppression pharmacokinetics and therapeutic drug monitoring. Part 2 - Maintenance Immunosuppression, 3. Drug Interactions and Safety, D) Other 1. Psychosocial Aspects of Organ Transplantation and Living Donation, 2. Regulatory Issues in Transplantation: CMS, UNOS, SRTR, Outcome reporting, 3. Women's Health Issues (Sexual, pregnancy, contraception)