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
Transplant Nephrology Fellowship Rotations
The experiences during the 12-month training period tally up to the following breakdown:
- 7 month (minimum) of inpatient rounds
- 1 month of tissue-typing lab and working with the organ procurement organization (OPO)
- 2 months of research – clinical or retrospective chart reviews
- 1 month of elective
- 1 month for vacation and to attend national conferences