Philadelphia University + Thomas Jefferson University

Liver Transplantation Anesthesiology

The Department of Anesthesiology at Thomas Jefferson University Hospital and the Sidney Kimmel Medical College offers a Liver Transplant Fellowship Program. The goal of this fellowship is to train anesthesiologists in the advanced perioperative care of liver transplant patients; integrating current best-practices, evidence-based care, and teaching of technical skills with each case. The trainee will not only participate in liver transplantations but also participate in cases with particular educational benefit as either a fellow or an attending; gaining experience as a staff member of the Department of Anesthesiology.

The transplant anesthesiology team plays an active role, not only in the operating room, but also throughout the care of the liver transplant patient by staffing a pre-operative anesthesia evaluation clinic, participating in a multidisciplinary hospital-wide transplant review committee, and constantly developing practices to improve our clinical practice.

The Jefferson Transplant Institute at the Sidney Kimmel Medical College has a distinguished history of organ transplant surgery and innovation in the Delaware Valley area. Past accomplishments include:

  • 1974 – Our first kidney transplant
  • 1984 – The first liver transplant in the Delaware Valley
  • 2010 – One of the first hospitals in the U.S. to use a totally artificial liver dialysis machine as a bridge to transplant for a patient with acute liver failure.

More recently, the Jefferson Transplant Institute has surpassed national averages for liver, kidney, and pancreas transplantation survival rates and has recently received a five-star rating from the Scientific Registry of Transplant Recipients; the highest in Pennsylvania for kidney and liver transplant outcomes. Jefferson has the lowest mortality rate among patients on the Region 2 (Pennsylvania, New Jersey, Delaware, Maryland, Virginia, West Virginia and the District of Columbia) liver recipient waiting list, and our patient and graft survival rates (93.8 percent and 89.9 percent respectively) surpass Scientific Registry of Transplant Recipients (SRTR) benchmarks as well as Organ Procurement Transplant Network (OPTN) regional and national levels.

Program Overview

As of 2016, Jefferson has performed annually, an average of 120 kidneys, 70 livers, and several pancreatic transplants, in addition to multiple dual organ transplants such as kidney and liver, and kidney and pancreas.

Liver anesthesiologists at Jefferson are also involved in managing anesthesia for hepatectomy; (partial lobectomy, trisegmentectomy, total left lobectomy, and total right lobectomy). Our department also has extensive experience in managing pancreatic and related surgeries; in a typical year; our surgeons perform approximately 200 pancreatic resections, including more than 120 Whipple procedures.

Fellows in the Liver Transplantation Anesthesia program are appointed in the Sidney Kimmel Medical College as Instructors and as licensed independent physicians. As part of the faculty of the Department of Anesthesiology, the trainee will have general anesthesiology call obligations and supervise anesthesia for a variety of general surgery cases. As the transplantation fellow, the trainee will have liver transplant call obligations and assist in the anesthetic management of approximately 70 liver transplants, annually.

Curriculum

The curriculum below is built upon the unit of four-week modules for clinical liver transplant anesthesia (6 modules), transplant critical care (1 module), point of care testing and simulation (1 module), Transesophageal echocardiography (2 modules), and transplant anesthesia scholarship (1 module).  These elements were considered to be essential to liver transplant anesthesia fellowship training and constitute 40 calendar weeks.  The remaining 8 weeks consist of elective rotations, which may include additional clinical transplantation anesthesia rotations, or critical care experience.  The fellow will have 3 weeks of vacation and 1 week meeting time during the one-year fellowship. 

Research

The liver fellow will participate in research program mentored by an attending faculty with experience in scholarly projects. Departmental financial and intellectual support is available with clinical or basic projects, and fellows are expected to be able to present research abstract at international liver transplant society meeting.

Diadactics

The transplant fellow will supplement their clinical experience with shared didactics in TEE with our Cardiac Anesthesiology division, weekly case review meetings, journal clubs, and QA/QI projects related to liver transplantation. Fellows are expected to prepare for the Basic Perioperative TEE exam, administered every two years.

Patient Care

The transplant fellow will enhance their cardiovascular, pulmonary, and hepatic physiology; and how to apply this knowledge to hepatic transplantation, major hepatic resections, and all phases of the perioperative period. In addition, the transplant fellow will gain additional experience with procedural skills, establish proficiency with management of end-stage liver disease, administration of anesthesia for liver transplantation, and many aspects of care in the operating room such as rapid infusion systems, real-time viscoeleastic testing, TEE, and blood management.

Faculty

Elia Elia, MD
Director of Liver Transplantation Anesthesiology
Program Director, Liver Transplantation Anesthesiology Fellowship

Mark Kim, MD
Associate Program Director

YooGoo Kang, MD
(Former Director of Liver Transplantation Anesthesiology)

George Hsu, MD

Stephen Goldberg, MD

Niraj Agarwalla, MD

CURRENT FELLOW: Uzung Yoon, MD

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Elia Elia, MD
Program Director


Applicant info

We are currently accepting applications for the fellowship in liver transplantation anesthesia for 2018 – 2019 academic year. We have one position annually, and accept applications on a rolling basis.

Candidate Requirements:
A valid Pennsylvania medical licence.

Interested candidates should email the Program Director, Dr. Elia Elia.

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