Kidney/Pancreas Transplant Operative Experience

The UCSF transplant fellow will have the opportunity to master back table preparation of the kidney and the pancreas, ex vivo vascular and ureteral reconstruction as necessary, kidney and pancreas transplantation, laparoscopic donor nephrectomy, and transplant nephrectomy. The estimated volume for each fellow is as follows:

• Kidney transplant = 100+
• Pancreas transplant = 15-20
• Laparoscopic donor nephrectomy = 40

In addition, the fellow is expected to participate in all operative cases related to complications of kidney and pancreas transplantation including exploration for bleeding or possible vascular thrombosis, repair of ureteral leak, ureteral revision secondary to obstruction, lymphocoele drainage (both laparoscopic and open), and enteric conversion of bladder-drained pancreas allografts. The fellow will have some exposure to dialysis access procedures and to occasional general surgery procedures performed on transplant recipients.

Liver Transplant Operative Experience

The fellow's operative experience on the Liver Transplant Service is extensive indeed. The fellow will be fully exposed to deceased and living donor transplantation for both adult and pediatric patients. This includes participating in living donor left lateral segmentectomy and right hepatic lobectomy. The estimated volume for each fellow is as follows:

• Adult liver transplantation = 65-70
• Pediatric liver transplantation = 6-8
• Living donor liver transplantation (adult and pediatrics) = 8-12
• Living donor hepatectomy (left lateral segmentectomy and right lobectomy) = 8-12

The fellow is expected to participate in all operative cases related to complications of liver transplantation including exploration for bleeding, repair of bile leak, and biliary revision for obstruction. The Liver Transplant Service also offers exposure to hepatic resections and occasional surgical shunt procedures (typically distal splenorenal or Rex shunts). Finally, during the past several years, there has been an increasing volume of operative radiofrequency ablation for hepatocellular carcinoma as either a bridging strategy to transplantation or as definitive therapy.