Transplant Nephrology Fellowship Program

This will involve work in both the outpatient and inpatient areas with a focus on patient care. Fellows are expected to attend inpatient rounds daily. While rounds cover all kidney and pancreas transplants, the fellow is primarily responsible for a subset of patients transplanted during their fellowship for whom they will maintain longitudinal care. The fellow also has a full clinic schedule including one donor clinic, one recipient evaluation clinic, one waitlist clinic, and three post-transplant clinics each week.

Fellows are expected to attend the living donor team meeting, the listing meeting, and the HLA (human leukocyte antigen) meeting to discuss the patients they saw over the prior week. In addition to direct clinical responsibilities, fellows attend the quarterly Quality Assurance and Performance Improvement (QAPI) meetings to review issues of patient and waitlist management and quality improvement in transplant centers. Fellows are encouraged to participate in existing QAPI projects and suggest their own projects as well.

For this month, the fellow’s primary responsibility is with the histocompatibility team. Fellows work under the supervision of Dr. Sandra Rosen-Bronson. Their activities in the lab will include a didactic component of selected talks from Georgetown’s “Current Topics in Transplant” audio conference series. They also participate in one-on-one case discussions with the histocompatibility laboratory director and technical supervisor. They observe all histocompatibility procedures relevant to renal transplantation, including HLA molecular techniques, antibody assays, and crossmatch assays.

By the end of the month, the fellow should have an excellent background in topics including:

During this month, fellows still attend the weekly listing meetings and HLA conference and maintain their post-transplant clinic responsibilities (though not the other outpatient clinics). They also continue to go to the weekly transplant lecture series. 

For this month, the fellow’s primary responsibility will be to develop a comprehensive basis for interpretation of transplant renal biopsies. The fellow will be working under the guidance of Dr. Bhaskar Kallakury. The fellow will be expected to be available to read all biopsies with Dr. Kallakury during this month as well as additional teaching cases to fill any gaps in the current clinical biopsies. The fellow will also be expected to perform (with the transplant nephrologists) all scheduled biopsies during this month.

To facilitate this, they will maintain only their basic clinical responsibilities of post-transplant clinics, the listing and HLA meetings, and the transplant lecture series.

Fellows spend their month in pediatrics at Children’s National Medical Center (CNMC) under the supervision of Dr. Asha Moudgil. They participate both in inpatient transplant rounds as well as outpatient transplant clinics for pediatric patients. The goals of this month are to appreciate the different challenges, both technical and social, for the transplantation of both young children and adolescents. Fellows learn the impact of transplant on growth and development and how the different needs in the pediatric setting demand different listing and allocation mechanics and how this differs from adult transplantation.

During this rotation, which is at a separate site, fellows do not have any clinical responsibilities at MedStar Health Georgetown University Hospital other than the standard didactic lecture components.

This rotation occurs late in the transplant fellowship year and provides intensive time for finishing the fellow’s year-long project and to write and submit a manuscript on their research. It is expected that by the beginning of this rotation, their work will be mostly complete, allowing for the focused time needed for final data analysis and publication.

During this month, the fellow’s only clinical responsibilities will be the post-transplant clinics and standard didactic lectures.