Transplantation

I.   Program Content

1. Immunology/Immunogenetics
1. Normal immune response.
   
2. Immune response to allografts.
   
3. Inflammatory response to allografts.
   
4. Mechanisms of tolerance.
   
5. Immunogenetics and tissue typing, cross matching, and surveillance for panel reactive antibodies.
   
2. Transplant Pharmacology
1. Basic principles of pharmacology and the mechanisms of action of immunsuppressant agents including: glucocorticoids, azathioprine, mycophenylate mofetil, cyclosporine, tacrolimus, sirolimus, and monoclonal and polyclonal antibodies.
2. Basic principles of pharmacology of nonimmunosuppressive medications used in transplant for the prophylaxis of infection and the treatment of concurrent illnesses with an emphasis on anticipating and managing drug interactions
3. Organ Sharing and Allocation.
4. Clinical Kidney and Pancreas Transplantation.
1. Historical perspective.
2. Pre-transplant evaluation of the recipient.
3. Pre-transplant evaluation of the living donor.
4. Pre-transplant evaluation of the cadaver donor/organ procurement.
5. Surgical technique and surgical management.
6. Physiology of the transplanted kidney.
7. Pathogenesis and pathology of allograft dysfunction.
8. Post-transplant care/in-hospital care.
9. Post-transplant care/out-patient care -- short and long term.
10. Expected clinical outcomes/analysis of risk factors.
11. Special considerations in pediatric renal transplantation.
12. Special considerations for pancreas transplantation.
5. Infectious disease in transplantation/pre- and post-transplantation.
6. Pregnancy and transplantation.
7. Cancer and transplantation.
8. Ethics of transplantation.
9. Economics of transplantation.

II.  Patient Care Experience

1. Pre-transplant:  Education, counseling, and evaluation of donor and recipient.
2. Immediate postoperative management: Evaluation and management of extracellular fluid volume, falling urine output, and primary nonfunction of the transplanted kidney.
3. Early post-transplant management: Establishment of adequate immunosuppression; diagnosis and therapy of rejection, infection, the hemolytic uremic syndrome, and urological and vascular complications; diagnosis and management of drug interactions and toxicities.
4. Long-term post-transplant management: Assessment for adequacy of immunosuppression; management of complications of long-term immunosuppression including medication-induced allograft dysfunction, recurrence of the primary disease, de novo post-transplant glomerulonephritis, post-transplant polycythemia, avascular necrosis, dyslipidemias, glucose intolerance, liver function abnormalities, lymphoproliferative diseases, and cancers affecting the skin and other organs.