Transplant Hepatology

Medical Knowledge:

Gastroenterology fellows completing this rotation will have an in depth knowledge of the following:

  1. Epidemiology,  pathophysiology, and clinical presentation of hepatitis C and B.
  2. Pathophysiology and clinical manifestations of autoimmune liver disorders including autoimmune hepatitis, PBC, and primary sclerosing cholangitis.
  3. Pathophysiology and clinical manifestations of alcoholic liver disease including alcoholic hepatitis and cirrhosis.
  4. Pathophysiology and clinical manifestations of NASH.
  5. Pathophysiology and clinical manifestations of portal hypertension, hepatic encephalopathy, and hepato-renal syndrome
  6. Pathophysiology and clinical manifestations of genetic disorders effecting the liver.
  7. Pathophysiology and clinical manifestations of fulminant liver failure.
  8. Indications for liver transplantation.
  9. Manifestations of acute cellular rejection, and chronic rejection  post liver transplantation.
  10. Laboratory evaluation of liver disorders.
  11.  Indications for liver biopsy, hepatic angiography, hepatic imaging procedures, and TIPS.

 

Patient Care:

Gastroenterology fellows completing this rotation will be able to evaluate, diagnose and manage the following conditions:

  1. Hepatitis B and C, autoimmune liver disorders, alcoholic liver disease, NASH, and genetic liver disorders (hemochromatosis, Wilson’s disease, alpha1 anti-trypsin deficiency, and others).
  2. Complications of cirrhosis including esophageal varicies, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome.
  3. An understanding and abillity to apply the methods employed to assess quality of care and initiate improvement projects in patients with liver disorders.
  4. A commitment to continuous improvement in the delivery of medical care including the appropriate use of liver transplantation.
  5. The ability to evaluate reported hepatic and related research, and use the information obtained from reviewing the literature to improve the care of patients with liver disorders.
  6. The ability to use information technology to manage practice information.
  7. The ability to use information technology to enhance professional development and continuing education.
  8. A willingness to participate in the education of students, residents and other health care professionals.
  9. Fulminant hepatic failure.
  10.  Problems developing in patients currently on the transplant list.
  11. Post liver transplantation problems including prevention of rejection, evaluation of graft failure, treatment of acute cellular and chronic rejection, treatment of recurrent hepatitis C and other infections post transplant.
  12. Patients with graft failure requiring re-transplantation.

 

Practice Based Learning and Improvement:

Gastroenterology fellows participating in this elective rotation will develop:

1.    A critical approach to the hepatology literature to facilitate review and

     assessment of the quality of reported scientific studies.

2.    An ability to apply the methods used to assess quality of care and initiate

quality improvement projects for patients with liver disorders..

3.    A commitment to continous quality improvement in the delivery of care to

      patients with liver disorders.

4.  The ability to evaluate reported research and use the information obtained from

      reviewing the literature to improve patient care.

4.    The capability of using information technology to manage data on patients with liver disorders.

5.  The ability to use information technology to enhance professional development

     and continuing education.

6.    A willingness to participate in the education of students, residents and other health care professionals involved in the care of patients with liver disorders.

 

Systems Based Practice:

Gastroenterology fellows participating in this elective rotation will:

1.    Be able to function as part of the liver transplant team.

2.    Understand and be able to participate in liver transplant committee meetings.

3.    Be able to function as a patient advocate for individuals with advanced liver disease.

4.    Be able to participate in the multidisciplinary management of patients with hepatocellular carcinoma.

 

 

Communication:

Gastroenterology fellows participating in this elective rotation will be able to:

1.    Create and sustain a therapeutic and ethically sound relationship with patients

 having advanced liver disease, and with their families.

2.    Communicate effectively with chronically ill patients and their families.

3.    Work with others as an effective team member.

4.    Counsel and educate patients and families concerning health issues relating to liver disease, transplantation, and expectations post treatment and transplantation.

 

Professionalism:

Gastroenterology fellows participating in this rotation will learn and/or demonstrate:

1.    Respect, compassion and integrity in all interpersonal relationships.

2.    A commitment to provide continued effort until patient care needs are completed or responsibility for them is transferred to another health care provider.

3.    An understanding of diversity issues treating all patients with respect and consideration.

4.    A commitment to the ethical principles pertaining to informed consent.

5.    Accountability to to patients, society and the profession.

6.    A commitment to lifelong learning and continued professional development.