Ochsner is a tertiary care referral facility with over 1000 physicians, 8 hospitals, and the largest transplant center in the region. In 2020 despite the struggles and uncertainty caused by the pandemic we performed149 single kidneys 17 simultaneous kidney/pancreas, 11 Combined Liver/Kidney and 3 Combined Heart Kidney transplants. We also have a very active Heart, Lung, Bone marrow and Liver alone transplant programs. Currently we have 3 full time Transplant Nephrologists, 9 Transplant Surgeons, 20 Transplant Coordinators, and 10 advanced practice providers a tissue typing laboratory, and a world class Renal Pathologist. We have all the structure necessary to provide excellent care to our transplant patients and education to our trainees. Ochsner kidney transplant program was ranked # 2 in the nation by Carechex in 2012, and our liver transplant program has been ranked #1 i from 2012 to 2016. In 2018 our heart transplant program performed the 1000th heart transplant since his creation in the 1970’s. Two graduates from our ACGME approved Nephrology Fellowship program have joined 2 well recognized Transplant Nephrology Fellowship training programs, which speaks of our commitment to the education of our Nephrology Fellows. Our Transplant Nephrology Fellowship program will develop a dedicated, competent, academically oriented Transplant Nephrologist, who will deliver the highest standard of care to transplant allograft recipients with medical renal disease. In this era of lifelong learning, the core competency model and patient safety remain critical to the delivery of health care that is compassionate and driven by evidence-based medicine. The Transplant Nephrology Fellow will have a crucial role in the assessment and management of our allograft recipients during the evaluation process, transplant, and postoperative management phase.
The Transplant Fellow (with supervision provided by the Staff Transplant Nephrologist) will be responsible for the evaluation of transplant recipients, discussion during transplant selection meeting, perioperative care, performance of allograft biopsies, and follow up in our outpatient clinic. The fellow will provide co-management responsibility with the Transplant Surgeon from the perioperative through the outpatient period for all kidney and pancreas transplant recipients. The fellow (as an integral part of the transplant team) will be responsible for the selection and administration of induction and maintenance immunosuppression according with accepted protocols in our institution. By the completion of training, the fellow with be well versed in all the indications, contraindications and the potential side effects of using various immunosuppressive agents. Our transplant fellow will be able to attend CME meetings, generous benefit package, junior faculty appointment at our institution, vacations and enough time to study and learn in depth the field of transplant nephrology. Our multidisciplinary approach will provide an unparalleled experience according with the new trends in the practice of evidence-based medicine. The transplant Fellow with supervision provided by the staff transplant nephrologist) will be responsible for the evaluation of transplant recipients, discussion during transplant selection meeting, perioperative care, performance of allograft biopsies and follow up in our outpatient clinic. The fellow will provide co-management responsibility with the transplant surgeon from the perioperative through the outpatient period in both deceased donor as well as living donor transplant recipients. The fellow (as integral part of the transplant team) will be responsible for the selection and administration of induction and maintenance immunosuppression according with accepted protocols in our institution. His/her input will be critical for the decision-making process including indications, contra-indications and potential side effects.
The program has access to a wide range of resources to support the educational mission. A diverse and committed faculty is a key resource of the program and essential for the orchestration of daily educational activities. Which include: Daily teaching rounds, core curriculum lectures; longitudinal outpatient clinics, pre transplant and donor clinic, patient safety conference (morbidity and Mortality); transplant selection meeting, QAPI, patient care meeting as well as renal pathology conference twice a week with Vanderbilt Department of Pathology. The curriculum is designed to provide a comprehensive review of the core topics in transplant nephrology. In addition, daily mentorship, review papers and input from all members from the transplant clinic will create the fund of knowledge for our trainee. (Please see below other educational resources) The supervising faculty member bears medical and legal responsibility for all final decisions relating to the management of potential transplant candidates, transplant recipient and complications related with patient care. Supervising faculty will be committed to the educational goals and objectives of the Transplant Nephrology training program. Accordingly, the schedule of the supervising faculty member will be adjusted to allow for protected time during teaching rotations for the supervision of the fellow in both the in-patient and out-patient settings. Teaching rounds will be approximately 3 hours per day. If a conflict between service duties and educational activities occurs, the supervising faculty will be responsible for patient care activities and the fellow will be instructed to attend the educational conferences. The program director will be responsible for maintaining the balance between education and clinical responsibilities
Please see below the topics covered during the core curriculum lectures: CORES TOPICS: Transplant Immunology Pharmacology/Immunosuppression Medical Complications of Transplantation Organ Allocation Pretransplant Evaluation of the Recipient Pretransplant Evaluation of the Living Donor Graft Dysfunction Expected outcomes/Risk factors Special Issues in Pediatric renal Transplantation Pregnancy and contraception Ethics of transplantation Pancreas transplantation Kidney transplantation in other solid organs transplant recipients Transplantation of ABO-incompatible and cross match incompatible individuals Paired kidney exchange program Business and administrative aspects of transplantation Resource materials to be used: Ochsner Medical Library provides access to subspecialty journal and the electronic media to assist the fellow in the preparation of journal clubs, case reports and renal biopsy conference. These can be accessed from any computer at Ochsner and can also access it remotely from home. The Fellow will have access to the renal transplant core curriculum sponsored by the American Society of Transplantation The transplant Fellow is also encouraged to attend the General Nephrology lectures. Transplant fellow will have access to the electronic learning resources offered by the American Society of Transplantation. The transplant core curriculum will not interfere with lecture schedule with General Nephrology didactics The program will cover expenses for a CME activity in the field of Transplant Nephrology .Also our trainee will have access to the ASN learning distance program where the fellow will be able to review core topics of transplant nephrology by national experts in the area Research Opportunities: In addition to the daily clinical activities, fellows will be encouraged to participate in research/scholarly activities and to publish abstracts and other publications (case report, case series). The fellow is also welcome to participate in pharmacologic company sponsored research. Under faculty mentorship will participate in the design of the research project: including the development of hypothesis to be tested, appropriate methodology, results and statistical analysis. Faculty members will provide the background reading and theory for research projects The IRB has a series of lectures titled “Responsible Conduct in Research” Lecture series 2015 which are given in a monthly basis the second Tuesday of the month at 12 noon time. In the lecture the speaker usually addresses FDA regulations, legal and ethical aspects of research. These lectures will be incorporated into the core curriculum for the transplant nephrology fellow. All the trainees participating in research are required to take the CITI (Collaborative Institutional Training Initiative) course for the protection of human subjects. Completion of the CITI course is one of the requirements for protocol approval by the IRB. Ochsner Health system provides access to the required training through an interactive online tutorial. Among other the fellows will be given the opportunity to apply to the National Kidney Foundation of Louisiana for the Scientific Advisory Boards funding program. We have a General nephrology fellowship training program (with 6 positions available) which was approved by the ACGME in 2012 and underwent a very successful site visit in June 2015. Each General Nephrology fellow rotates 1 month per year (total 2 months during the entire training). We also have Nephrology fellows from Louisiana State University (LSU). About 6 months a year according with LSU schedule. We maintain an excellent relation with both programs and are delighted to provide a very comprehensive educational experience to both institutions. As a testimony two of our graduates chose to pursue a career in transplant nephrology and obtained positions at top class institutions in the United States. Due to the transplant volume in the last 5 years, we have observed a significant increase in-patient census, outpatient referrals, transfers from other institutions, transplant allograft biopsies and outpatient follow ups, therefore we have no doubt that all the trainees will have enough patients to meet their educational needs. Staff transplant nephrologist will meet with rotating fellow and transplant fellow to discuss patient assignment daily. New consults will be distributed in a sequential fashion to maintain balance and fairness. In the case more than a fellow is on the in-patient service the new consults will be rotated daily as well as the new transplants to maintain continuity of care throughout the period rotating in the acute setting.