Program Highlights

The Transplant Nephrology Fellowship at Ohio State's Wexner Medical Center provides fellows with extensive inpatient and outpatient clinical experience, as well as longitudinal didactic teaching.

The program prepares fellows to:

• Manage kidney and pancreas transplant recipients at all stages of their care
• Become competent in immunosuppressive regimens
• Diagnose and manage complex nephrology issues 

The Transplant Nephrology fellow is expected to perform at the level of a junior faculty member since he or she has completed the traditional nephrology fellowship and is board eligible. Therefore, fellows are allowed a significant amount of input in all decisions regarding immunosuppression as well as patient management.

Our Comprehensive Transplant Center

The Comprehensive Transplant Center at Ohio State's Wexner Medical Center is one of the largest organ transplant programs in the nation, performing approximately 200 kidney and 30 pancreas transplants annually.

The four full-time transplant nephrologists participate in all aspects of patient management, working alongside the transplant surgeons. Post-transplant care is provided as a multidisciplinary, collaborative model both in inpatient and outpatient settings. The center also provides long-term care for the duration of the allograft function, regardless of longevity.

Application Process

If you are interested in applying for the Transplant Nephrology Fellowship at Ohio State, you will need to contact us with these documents:

• Letter of interest
• CV, including publications
• Three letters of recommendation
• United States Medical Licensing Examination (USMLE) transcript

Mail or email the above to:

Uday Nori, MD
Program Director
Uday.Nori@osumc.edu

The Ohio State University Wexner Medical Center
Division of Nephrology
395 W. 12th Ave., Ground floor Columbus, OH 43210

Curriculum

Transplant immunology

• Normal immune response
• Response to allografts
• Tolerance
• Crossmatches, flow cytometry
• Identification of anti-HLA (human leukocyte antigen) antibodies and donor-specific antibodies

Pharmacology and immunosuppression

• Immunosuppression agent categories
• Review mechanisms of the agents
• Current pharmacotherapy
• Investigational agents
• Therapeutic drug monitoring of immunosuppressive therapies
• Steroid avoidance and withdrawal
• Calcineurin inhibitor (CNI) elimination, minimization and withdrawal
• Drug interactions
• Drug adverse effects
• Long-term reduction of immunosuppression

Medical complications of transplantation

• Opportunistic infections
• Bacterial
• Viral
• Fungal
• Hypertension
• Atherosclerosis
• Hyperlipidemia
• New onset of diabetes after transplantation (NODT)
• Transplant-associated malignancies
• Viral-driven malignancy, including post-transplant lymphoproliferative disease (PTLD), cervical cancer, Kaposi’s sarcoma, nasopharyngeal cancer
• Non-virally driven malignancy, such as renal cell and skin
• Hepatobiliary disease, hepatitis C virus
• Musculoskeletal, bone and mineral metabolism
• Post-transplant erythrocytosis
• Metabolic syndrome

Organ allocation

Pre-transplant evaluation of the recipient

Evaluation of the living kidney donor

Graft dysfunction

• Acute rejection – cell-mediated and antibody-mediated
• Chronic rejection, chronic allograft dysfunction
• Surgical and operative complications
• Infection
• Nephrotoxicity
• Recurrent glomerular disease
• De novo disease
• Renal artery stenosis

Expected outcomes and risk factors

• Living related donor (LRD)
• Deceased donor organs
• Standard criteria donor (SCD)
• Expanded criteria donor (ECD)
• Donation after cardiac death (DCD)
• Pediatric en bloc
• Living unrelated donor (LURD)
• Race
• Human leukocyte antigen (HLA) matching
• Relapse of native kidney disease

Special issues in pediatric renal transplantation

Pregnancy and contraception

Transplantation ethics

Pancreas transplantation

Kidney transplantation in other solid organ transplant recipients

• After other organs
• Combined kidney and “other” organ

Transplantation of ABO-incompatible and cross-match incompatible individuals

Paired kidney exchange programs

Business administrative aspects

• Review of Banff criteria
• Acute and chronic rejection, subclinical rejection
• Calcineurin inhibitor toxicity
• Recurrent disease
• C4d staining
• BK virus nephropathy
• Thrombotic microangiopathy
• Clinical management of pathologic findings
• Protocol transplant biopsies

Research

Fellows participate in a variety of ongoing or new clinical research projects related to kidney disease or kidney and pancreas transplantation.

Resource Materials

The following are some of the primary materials that the transplant fellow is expected to use for training. In addition, journal articles will be used as supplementary materials on a regular basis.

• Handbook of Kidney Transplantation, fifth edition – Danovitch G. 
• Primer on Transplantation, third edition – Hricik D.
• Transplant Nephrology Core Curriculum by the American Society of Nephrology