Liver Transplantation Anesthesiology
The Department of Anesthesiology at Thomas Jefferson University Hospital and the Sidney Kimmel Medical College offers a Fellowship Program in Anesthesia for Liver Transplantation. The primary goal of this fellowship program 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. Our fellow will not only participate in liver transplantations but also participate in cases with particular educational benefit as either a fellow or an attending; gaining valuable experience overall as a consultant in Anesthesiology.
The liver transplant anesthesiology division 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 reviewing our collective practice to provide the best anesthesia experience for each patient.
Our division works closely with the Jefferson Transplant Institute at the Sidney Kimmel Medical College. The Jefferson Transplant Institute has maintained a reputation for surpassing national averages for liver, kidney, and pancreas transplantation survival rates. We have directly contributed to Jefferson achieving the only 5 out of 5 rating in the Philadelphia-area by the Scientific Registry of Transplant Recipients for liver transplantation one-year graft survival outcomes and is among the top 8 percent in the country (Source: Scientific Registry of Transplant Recipients, August 2020 report).
We are currently accepting applications for the fellowship in liver transplantation anesthesia for 2022–2023 academic year. We have one position annually, and accept applications on a rolling basis.
- A valid Pennsylvania medical license.
Interested candidates should email the Program Coordinator, Kymberley Ballato.
Fellowship Program Overview
Since 2013, the annual liver transplant rate has increased at Jefferson; peaking at 89 liver transplants in 2019. This figure includes dual organ transplantation (kidney & liver) and occasional living-donor liver transplantation.
Liver transplant anesthesiologists at Jefferson are also involved in managing anesthesia for hepatectomies; (partial lobectomy, trisegmentectomy, total left lobectomy, and total right lobectomy). Our department also has extensive experience in managing pancreatic and hepatobiliary surgeries. In a typical year, Jefferson surgeons perform approximately 200 pancreatic resections, including more than 120 Whipple procedures. Fellows would have the opportunity to manage the anesthetics for these cases.
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 also have general anesthesiology call obligations as an attending anesthesiologist and supervise anesthesia for a variety of general surgery cases. In addition, as the liver transplant fellow, the trainee will have liver transplant call obligations and assist in the anesthetic management of approximately 80 liver transplants, annually.
The curriculum below is built upon four-week blocks:
- Clinical liver transplant anesthesia (6 blocks / 24 weeks)
- Transplant critical care (1 block / 4 weeks)
- Point of care testing and simulation (1 block / 4 weeks)
- Transesophageal & Transthoracic echocardiography training (2 blocks / 8 weeks)
- Transplant anesthesia scholarship (1 block / 4 weeks)
These elements are considered to be essential to liver transplant anesthesia fellowship training and constitute 44 calendar weeks. The remaining two blocks consist of elective rotations, which may include additional clinical transplantation anesthesia rotations, non-liver critical care experience, or additional time for scholarship. The fellow will have four weeks of vacation and one week meeting time during the one-year fellowship.
Research & Education
The liver fellow will participate in a research program mentored by an attending faculty with experience in scholarly projects. Departmental financial and intellectual support is available for clinical projects. Fellows are encouraged to be able to present a research abstract at the annual International Liver Transplant Society (ILTS) meeting.
The liver transplant fellow will actively learn how to teach and train resident anesthesiologists in the operating room as the transplant fellow during a liver transplant or as an attending anesthesiologist during non-transplant cases.
The transplant fellow will supplement their clinical experience with shared didactics in transesophageal echocardiography (TEE)/TTE 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.
The transplant fellow will enhance their knowledge of cardiovascular, pulmonary, and hepatic physiology; and apply this knowledge to evaluate the potential liver transplant patient and care for the liver transplant and hepatobiliary surgery patients throughout all phases of the perioperative period. In addition, the transplant fellow will gain valuable experience with procedural skills and many less common aspects of care in the operating room such as rapid infusion systems, real-time viscoeleastic testing (ROTEM), TEE, and blood product management.
Mark Kim, MD
Director, Liver Transplantation Anesthesiology
Uzung Yoon, MD
Program Director, Liver Transplantation Anesthesiology Fellowship
YooGoo Kang, MD
Co-Founder & First President of the International Liver Transplant Society (ILTS)