Transplant Hepatology Fellowship

Program Overview

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The University of Virginia’s Transplant Hepatology Fellowship Training Program is a one-year program designed to prepare physicians for a career in academic general and transplant hepatology.

The fellowship is designed to meet the ACGME and ABIM requirements to be eligible to take the ABIM Transplant Hepatology board exam and provide the experience required to serve as a UNOS-certified primary liver transplant physician for an accredited liver transplant center in the U.S.  UVA has an multi-disciplinary, team approach to liver transplantation with close collaboration between transplant hepatology and transplant surgery services. The transplant clinic space is shared by both services 5 days per week. Joint daily rounds occur on the inpatient transplant service.

Transplant Hepatology Fellows have access to comprehensive training in transplant hepatology, advanced general hepatology, hepatology-focused endoscopy, transplant infectious diseases, hepatopathology, and interventional radiology, as well as mentoring in clinical research, advanced clinical skills, and education techniques.

The UVA Liver Transplant Program is a UNOS-accredited liver transplant program and has performed over 1,400 liver transplants since its origin in 1988, and it was the first liver transplant program in Virginia. In CY 2018, 401 new liver transplant evaluations were undertaken, 148 patients were added to the waiting list, and 99 transplants were performed. The program is currently caring for over 700 transplanted patients. UVA draws most of its patients from Virginia, West Virginia, Tennessee, and North Carolina but also receives referrals from the greater mid-Atlantic region and New England as well as California and Colorado. The program offers multi-organ transplantation as well as split, domino, and living donor liver transplantation. The transplant staff includes 8 hepatologists, 4 liver transplant surgeons, 1 PA, 4 NPs, 7 nurse liver transplant coordinators, a dietician, 3 social workers, 1 clinical psychologist, and administrative support. Transplant patients are evaluated in clinic every weekday. UVA also has a pediatric liver transplant program that is integrated with the Liver Transplant Program. Adult hepatology trainees gain experience in pediatric liver disease management during joint pathology, radiology, and transplant selection conferences.

Supervision and mentorship is provided by an exceptional team of Transplant Hepatologists: Drs. Curtis Argo, Zachary Henry, Nicolas Intagliata, Patrick Northup, Bethany Reutemann, and Matthew Stotts. The program is also supported by Drs. Stephen Caldwell and Neeral Shah.

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Eligibility

The training year commences in July. Candidates must have completed both an ACGME-accredited Internal Medicine residency and Gastroenterology and Hepatology fellowship. The UVA Transplant Hepatology Program looks to attract trainees who plan to pursue full-time Transplant Hepatology careers in academic medical centers.

Clinical Activities

Our transplant hepatology fellow participate in various clinical activities during the training year including rotation on the inpatient liver transplant service. The patients cared for on this service are typically new transplant recipients within the first year after liver transplant. On the inpatient service, the transplant hepatology fellow works closely with the transplant surgeons, transplant hepatologists, transplant surgery fellow, and inpatient transplant surgery NP team. Throughout the year, the transplant hepatology fellow routinely rounds on inpatients in the morning with the transplant team and transplant hepatology attending physician, transitions to outpatient clinic or endoscopy in the middle portion of the day, and then returns to the ward to complete the daily inpatient transplant care and rounds with the consulting transplant hepatologist. Outpatient clinics include a focus on caring for patients in all phases of the liver transplant process (pre-, peri-, and post-transplantation) with more limited exposure to advanced general hepatology patients with complicated cirrhosis care.

In addition to expected participation at our weekly hepatopathology review conference, the transplant fellow is encouraged to pursue elective experiences with interventional radiology, abdominal radiology, transplant infectious disease, transplant endocrinology, and transplant nephrology.  These experiences typically occur interspersed throughout the year and are arranged by the transplant hepatology fellow at their convenience to gain broad exposure but also to address specific gaps in experience and knowledge in order to finish training as a well-rounded, confident clinician and colleague.

Clinical Research

Clinical research projects are an expectation for our transplant hepatology fellow. Balancing clinical and educational opportunities with research is an important skill in developing an academic hepatology career. Generally, our fellow has 4-6 hours per week set aside for clinical research pursuits.

Conferences/Meetings

Living Donor Transplant Review Meeting (weekly – Wednesday, 11:30 AM-12:30 PM)

Post-Transplant Clinical Care Meeting (weekly – Wednesday, 12:30-1:30 PM)

Liver Pathology Conference (weekly – Wednesday, 1:30-2:15 PM)

Liver Transplant Selection Meeting (weekly – Wednesday, 3:00-4:30 PM)

GI/Hepatology Grand Rounds (weekly – Wednesday, 7:30-8:30 AM)

Hepatology Journal Club or Case Conference (monthly – Wednesday, 11:30 AM-12:30 PM)

Multidisciplinary Liver Tumor Management Conference (weekly – Friday, 3:30-5:00 PM)

Transplant Lecture Series (weekly – Friday, 8:00-9:00 AM)

Transplant Hepatology Fellows are also encouraged to attend the usual palette of educational events available to the GI/Hepatology fellows including pathophysiology conference, core curriculum lectures, and GI/Hepatology journal club.