Liver Transplantation Anesthesiology

The Department of Anesthesiology offers a non-ACGME accredited Liver Transplantation Anesthesiology Fellowship position starting in July of each year. One annual fellowship position is available and is open to national competition. The primary goal of this fellowship program is to train anesthesiologists in the advanced perioperative care of liver transplant patients; integrating current best-practices, evidence-based care and teaching of technical skills with each case. Our fellow will not only participate in liver transplantations but also participate in cases with particular educational benefit as either a fellow or an attending; gaining valuable experience overall as a consultant in Anesthesiology and learn how to design and complete clinical research projects independently.

Our Liver Transplantation Anesthesiology Fellowship focuses on the multidisciplinary approach with close ties to Hepatology, Transplantation Surgery, Blood Bank, Cardiology, Psychiatry and Critical Care. Inpatient services are provided at Thomas Jefferson University Hospital, Center City Campus. The Department of Anesthesiology annually provides services for 90 Liver Transplantation procedures, and is expected to increase with the expansion of the Jefferson Health System. The Jefferson Transplant Institute has maintained a reputation for surpassing national averages for liver, kidney, and pancreas transplantation survival rates. Jefferson has achieved the only 5 out of 5 rating in the Philadelphia-area by the Scientific Registry of Transplant Recipients for liver transplantation one-year graft survival outcomes and is among the top 8 percent in the country (Source: Scientific Registry of Transplant Recipients, August 2020 report).

• Ensure that the fellow becomes an expert in the perioperative management of liver transplantation candidates. This includes pre-, intra-, and postoperative care.
• Become an expert in coagulation management using real-time viscoelastic testing (ROTEM) and learn the administrative duties in running an accredited Clinical Laboratory Improvement Amendments (CLIA) laboratory.
• Become proficient in utilizing intraoperative transesophageal echocardiography to guide decision making and with the goal of certification in perioperative transesophageal echocardiography through the National Board of Echocardiography (NBE).
• Attain procedural skills necessary for the comprehensive care of liver transplantation patients including vascular access, PA-Catheter placement and echocardiography.
• Communication and coordination of multidisciplinary teams, and cultivate leadership and teaching skills in the intraoperative setting.

Fellows complete thirteen 4-week rotations across the Liver Transplantation service line with emphasis on the perioperative management of liver disease.

In addition to nine dedicated rotations in the liver operating rooms, optional electives include: Blood Bank/Transfusion Medicine, Cardiac Cath Lab, Transthoracic Echo, Surgery, Critical Care, Perfusion, Pediatric Liver Anesthesiology, and Research. The fellow will have the flexibility and discretion to select the elective rotations that fit the best for his education. The fellow will be attending the outpatient liver transplantation anesthesiology clinic twice a week with an attending, and will function as a full fellow for 120 days and as an attending for 120 days.

The call schedule will be flexible to maximize the amount of exposure to the liver transplant procedures. Priority will be to be assigned to any available liver transplant procedures. The fellow will be responsible for carrying the liver transplant anesthesia consult pager throughout the year for in-house consults (except on post-call days and vacations).

Didactic program includes weekly lectures or case conference on advanced topics in Liver Transplantation Anesthesiology, biweekly Liver Transplantation candidate listing committee, Anesthesiology Grand Rounds and Liver Surgery Morbidity and Mortality Conference

The liver fellow will participate in a research program mentored by an attending faculty with experience in scholarly projects. Departmental intellectual support is available for clinical projects. Fellows are encouraged to be able to present a research abstract at the annual International Liver Transplant Society (ILTS) meeting and Society for the Advancement of Transplant Anesthesia (SATA).