Abdominal Multi-Organ Transplant and Hepatopancreatobiliary Surgery Fellowship
Abdominal Multi-Organ Transplant and Hepatopancreatobiliary Surgery Fellowship at the MedStar Georgetown Transplant Institute is a two-year clinical training program through the Georgetown University School of Medicine embedded in the transplant institute at MedStar Georgetown University Hospital.
The fellows work with 14 transplant and 4 HPB staff surgeons. Meet the faculty.
In the first few months, senior fellows train the junior fellows on deceased donor organ recovery and transition them to independent surgeons. By end of the first year, junior fellows become independent on kidney transplants, and most steps of liver transplants and many HPB surgeries. During the second year, the autonomy increases significantly during all organ transplants and HPB cases. Fellows often take on the role of teaching surgeons for junior colleagues.
The fellowship consists of:
Adult and pediatric multi-organ abdominal transplant
- Liver (donation after brain death, donation after cardiac death, living donor, split, domino)
- Transplant oncology (intrahepatic cholangiocarcinoma, hilar cholangiocarcinoma, metastatic neuroendocrine tumor, colorectal metastasis to the liver)
- Intestine (modified and multi-visceral)
- Kidney (living donor, deceased donor, National Kidney Registry, laparoscopic living donor)
- Pancreas
and hepatopancreatobiliary (HPB)
- Liver (benign and malignant, open and robotic resection, hepatic artery infusion pump )
- Pancreas (benign and malignant, open and robotic, pancreaticoduodenectomy, total pancreatectomy with auto islet cell transplant, drainage procedures for pancreatitis, intraoperative radiation therapy )
- Duodenum (open and robotic duodenal resection and whipple)
- Biliary tree (open and robotic biliary tree injury reconstruction, choledochal cyst, hilar cholangiocarcinoma, Spyglass common bile duct exploration)
We aim to train outstanding clinical and academic abdominal multi-organ transplant and hepatopancreatobiliary surgeons for future leadership in the field.
MGTI is one of the country's largest and busiest transplant and HPB programs. Procedures we encounter include pediatric domino liver transplant, pediatric split-liver transplant, living donor transplant, complex pediatric and adult multi-visceral transplant, complex kidney and liver transplants, and complex HPB resection and reconstruction. Our robotic HPB program is one of the busiest in North America with a variety of complex HPB cases.
Why train here
The training in Abdominal Multi-Organ Transplant and Hepatopancreatobiliary Surgery Fellowship is broad-based training, including all aspects of transplant and HPB surgery. Trainees enjoy a wide variety of cases and academic training, with the opportunity to pursue a career in either organ transplants, HPB, or a combination of both. Trainees learn minimally invasive living donor nephrectomies and pediatric and adult living donor hepatectomies and transplants along with donation after brain death (DBD) and donation after cardiac death (DCD). They will also learn about normothermic perfusion pumps and liver recovery and improvement techniques.
HPB cases include a variety of open and robotic aspects. Fellows become independent in open and most of the robotic surgical techniques, and they learn the pre-operative planning and management of patients, along with oncologic management of post-surgical resection, volumetric measures, and surgical planning.
Fellows obtain ASTS certification on abdominal multi-organ transplant and hepatobiliary surgery, and one out of two fellows each year also receives the AHPBA certificate of HPB surgery from the fellowship Council. Fellows also can obtain a robotic surgery certificate, if interested.
The Institute model provides training independence by accommodating fellows with personalized learning plans and opportunities.
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The New Transplant Floor at the Verstandig Pavilion
Curriculum and Didactic teaching
We follow the fellow’s curriculum on ASTS Academic Universe on transplant. Fellows are given the schedule for the year, and on a bi-weekly schedule, they review designated modules and take the quizzes, and on every other Monday at 4 p.m. they review the modules with one designated staff surgeon.
For HPB, we follow the Fellowship Council’s Advanced GI Curriculum for Hepato-Pancreato-Biliary Surgery Fellowship. We also have our weekly HPB grand rounds on Fridays, called HPB Pizza Rounds, with a variety of topics from sentinel paper reviews to case reviews, talks, and discussions. Residents on service are actively involved with this session and fellows run the discussion with 3 HPB attending surgeons involved in training and teaching.
The Fellowship program offers multiple opportunities for additional learning through
- Transplant and HPB Seminar Series
- Transplant Conferences: Live Donor, Listing, and Quality
- Multi-Organ Transplant Rounds
- Scheduled ASTS and AHPBA Module Reviews
- Journal Clubs (offered for both HPB and Transplant)
- Transplant Grand Rounds and Invited professors
- HBP Grand Rounds, Liver Tumor Board, Pancreas Tumor Board, GI Oncology Tumor Board
The following regularly scheduled rounds and conferences are held:
| Date | Frequency | Name | Mandatory |
| Monday 12 to 1 p.m. | Weekly | Kidney Living Donor Selection Committee | |
| Monday 1 to 2 p.m. | Monthly | Liver Living Donor Review | |
| Monday 3 to 4 p.m. | Weekly | Post Liver Transplant Review | |
| Monday 4 to 5:30 p.m. | Bi-weekly | Fellows Transplant Module Review | mandatory |
| Tuesday 7 to 8 a.m. | Weekly | General Surgery M&M | |
| Tuesday 1 to 2 p.m. | Weekly | Hepatology Core Curriculum | |
| Tuesday 3 to 4 p.m. | Weekly | Liver Transplant listing selection committee | |
| Tuesday 4 to 5 p.m. | Weekly | Liver HPB Tumor Board | |
| Wednesday 9:30 to 10:30 a.m. | Weekly | Intestine and Multi Visceral Review Committee | |
| Wednesday 12 to 1 p.m. | Weekly | Kidney Transplant Listing Selection Committee | |
| Wednesday 1 to 2 p.m. | Weekly | HLA meeting | |
| Wednesday 1 to 2 p.m. | Quarterly | Liver Quality Review Committee | |
| Wednesday 1 to 2 p.m. | Quarterly | Kidney Quality Review Committee | |
| Wednesday 1 to 2 p.m. | Quarterly | Intestine/MVT Quality Review Committee | |
| Wednesday 1 to 2 p.m. | Quarterly | Pediatric liver Review Committee | |
| Wednesday 5 to 6 p.m. | Weekly | GI Oncology Tumor Board | |
| Thursday 4 to 5 p.m. | Weekly | Pediatric liver and intestine/MVT listing | mandatory |
| Friday 8 to 9 a.m. | Weekly | Transplant Grand rounds/ M&M | mandatory |
| Friday 12 to 1 p.m. | Weekly | HPB grand rounds (Pizza rounds) | mandatory |
| Friday 1 to 2 p.m. | Weekly | Pancreas HPB Tumor Boards | mandatory |
Research opportunities
Research is an integral part of MGTI fellowship programs. Fellows have multiple opportunities during their fellowship along with extensive help in research projects and are encouraged to get involved with as many projects as possible.
MGTI has a large set of databases on all organ transplants, HCC, Pancreas cysts and cancers, and intestinal transplants. Fellows have access to all of those and under the direct supervision of attendings, they can work on many clinical outcome projects.
- Each fellow is required to finish at least one research project along with at least one national conference presentation during two years of fellowship. More is strongly encouraged.
- Fellows have the choice of basic science or clinical outcome research projects both in transplant and/or HPB fields.
- There will be basic science opportunities for laboratory-based research on the topics of
- Ischemia/reperfusion
- Rejection
- Intestinal Transplant Rejection
- Tolerance
- Hepatocellular carcinoma (HCC)
- Fellows take all the requirements for IRB and research protocols required by MGTI at the first month of fellowship.
Rotations and resources
Rotations
By embedding in MGTI, fellows and surgeons closely collaborate with transplant hepatology and transplant nephrology in patient care and training.
Inpatient care is consistent with close collaboration between the fellow who covers the fellow and with attending on-call. The inpatient care is covered by 16 advanced practitioner providers (APPs) on a 24/7 basis. Consults and new patients will be seen primarily by residents rotating on service and will be run by fellow and attending.
Fellows rotation is on weekly bases. It consists of 4 total rotations of the floor, operating room, kidney, and pediatric plus donor services.
After selection to the HPB track, the designated fellow will have 6 weeks in the first year and 12 weeks in the second year of dedicated HPB rotation and clinic and will be completely removed from donor or transplant responsibilities with the exception of the weekend call schedule. During those 3 months of service, the rotating chief resident will cover the weekly rotation of fellows as needed.
The first three to four months of fellowship are designed for senior fellows and attending surgeons to train the junior fellows for donor surgeries.
Time off
Fellows have four weeks of vacation during each year of fellowship plus the time off for presentations and job interviews.
Fellows have one full weekend off and two 24-hour shifts off during the rest of the month. The floor fellow covers the weekend call along with the donor fellow on call for donor surgeries.
Discover life in Washington, DC
Washington, DC, is a vibrant city in close proximity to many other big cities. Whether you’re looking to blaze a trail or relax, social opportunities abound. The District offers running, walking, and biking trails, kayaking and boating on the Potomac River, and a dynamic restaurant scene.
During slow times, there are weekly markets and bazaars around the hospital to discover. On campus at Georgetown University, enjoy a weekly fresh-air food market where students and faculty can mingle over lunch.