Liver Transplant Division
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Resident Jason Scafidi, MD learns the finer points of Liver Transplant Anesthesia from Dr. Eryn Thiele, M.D.
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Stephen Collins, MD and Dr. Amanda Kleiman, MD & Liver & Transplant Anesthesia Division Chief prepare residents for a transplant case.
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Stephen Collins, MD teaches Transplant Anesthesia to Dr. Chelsea Ann Patry, MD.
About
The Liver Transplant Anesthesia Division provides specialty care to patients undergoing hepatobiliary as well as abdominal transplant surgeries. We aim to provide cutting edge clinical care for these patients, including the use of ERAS protocols, advanced monitoring techniques, continuous cardiac output PACs, and transthoracic & transesophageal echocardiography.
Our division is extensively involved in the education of residents. Several members of the group serve as members of the Residency Leadership Committee. Our faculty lead a biannual liver and coagulation teaching block and offer a liver transplant elective for our CA3 residents, visiting USN residents, and interested residents from other anesthesia residency programs. Please reach out to inquire about ways to rotate with our division.
A Message from the Division Chief
Katherine Forkin, MD
Division Chief Liver Transplant Anesthesia
Welcome to the Division of Liver Transplant Anesthesia Web Page. We have a robust clinical practice of hepatobiliary surgery as well as abdominal transplant performing 70-100 livers, 150-200 kidneys, and approximately 20 pancreas transplants per year. We are actively involved in educational endeavors as well as clinical research projects to advance the education of our residents and the care of our patients.
Our Division
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Katherine T. Forkin, MD
Liver Transplant
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Lliam Brannigan, MBBCH
Critical Care, Liver Transplant, Perioperative Medicine
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Stephen R. Collins, MD
Liver Transplant
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Hamy Kassahun, MD
Liver Transplant
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Amanda M. Kleiman, MD
Cardiothoracic, Liver Transplant, Obstetrical
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Eryn L. Thiele, MD
Liver Transplant
Resident Rotation
UVA performs all solid organ transplants except small bowel transplants, and residents get an early and extensive exposure to these complex and exciting cases. Beginning in the CA0 year, residents may participate in a living or deceased donor kidney transplant, of which we perform around 120 procedures per year. During the CA1 year, it is possible to complete liver transplants (70-80/year) which can be some of the most challenging anesthetics to perform due to the massive blood loss, metabolic derangements, arrhythmias, and fluid shifts.
Our CA2 and CA3 residents have more opportunity to participate in liver transplants, including a capstone CA3 liver transplant rotation where they cover all transplants which occur and solidify their management of these difficult cases. Additionally, residents have the opportunity to take care of heart transplant patients (about 30/year) and lung transplant cases (around 30-50/year and growing).
Most of our residents choose an elective transplant rotation during their final year of training.
The Growth of Our Clinical Volumes
See the chart below.
Liver Transplant Anesthesia Research:
- Completed enrollment of 40 liver transplant patients evaluating Quantra Q-stat (a new viscoelastic monitoring device) in comparison to results obtained from ROTEM as part of a multicenter trial (Forkin PI)
- Published key articles in premier anesthesia journals related to transplant anesthesia as well as other topics
- Several Resident Case Presentations at National Meetings (ASA, IARS, liver society meetings)
- Effects of CirQPOD Intrathoracic Pressure Regulation on Non-invasive Cardiac Output in Patients Undergoing Hepatic Resection
- Utility of Pre-operative Transthoracic Echocardiogram to Predict Day-of-Transplant Right Heart Hemodynamics
- Evaluation of the Clinical Performance of the Quantra System with the QStat Cartridge in Trauma and Liver Transplantation
Publications:
Forkin KT, Colquhoun DA, Nemergut EC, Huffmyer JL. “The coagulation profile of end-stage liver disease and considerations for intraoperative management.” Anesth Analg. 2018 Jan;126(1):46-61.
Walters SM, Richter EW, Lutzker T, Patel S, Vincent AN, Kleiman AM. “Perioperative Considerations Regarding Sex in Solid Organ Transplantation.” Anesthesiol Clin. 2020 Jun;38(2):297-310.
Leaders in state and national societies
- American Society of Anesthesiologists: Committee on Transplant Anesthesia
- DC/Maryland/Virginia Liver Transplant Anesthesiologists: Annual Meeting Planning Committee
- ERAS for Liver Transplantation (ERAS4OLT): Expert Working Group Panel Member, Coagulation & Transfusion
- A&A Editorial Board Membership