Thank you for your interest in the Transplant Surgery Fellowship Program in the Department of Surgery of the University of Wisconsin Department of Surgery. We offer four two-year positions, three in odd years and one in even years. Our Transplant Surgery Fellowship is accredited by the American Society of Transplant Surgeons for training in kidney, liver and pancreas transplantation.
The Transplantation Program is based at University of Wisconsin Hospital and Clinics, a 503-bed, tertiary care facility serving the people of Wisconsin and the Midwest. Every year, surgeons here perform 14,000 inpatient and 5,500 outpatient operations. About 500 of these are organ transplants. The Division of Transplantation is part of the Department of Surgery. Other divisions in the department are Cardiothoracic Surgery, General Surgery, Otolaryngology, Plastic and Reconstructive Surgery, and Vascular Surgery.
The Transplantation Program at the UWHC emphasizes several major issues:
- Surgical aspects of kidney, pancreas, and liver transplantation, with an emerging interest in small bowel transplantation and islet transplantation. We also have a strong interest in vascular access and general surgery for the post-transplant patient.
- Clinical immunosuppression of the transplant recipient and basic research in immunobiology
- Management of postoperative surgical complications and long-term medical management of the transplant recipient
- Organ procurement procedures and the principles of organ preservation
The Division of Transplantation is staffed by four transplant fellows, a third-year surgical resident, an intern, one medical fellow, and five physician assistants. Fellows rotate through pancreas, liver, and kidney transplant rotations as well as gain exposure to vascular access and organ procurement.
Fellows have primary clinical responsibility for liver, pancreas, and kidney transplant recipients. They are involved in organ procurement, especially when the donor is a multi-organ donor. They share assignments on deceased donor kidney transplants with the third-year surgical resident. They assist while faculty perform live donor kidney transplants.
The University of Wisconsin is ranked consistently among the most active transplant centers in the nation. We perform approximately 350 kidney transplants annually, nearly half of which are living donor transplants. We perform approximately 90 liver transplants annually and 65 to 70 pancreas transplants – usually combined with a kidney transplant. We are also performing heart, heart-lung, single- and double-lung, multivisceral and islet transplants.
These numbers will likely remain stable, for they are directly influenced by the number of available donors in an area with a fixed population. We may see a continuing increase in the number of liver and pancreas transplants. We will continue to do multivisceral and islet transplants on a case-by-case basis.
Rounds and Clinics
All transplant patients are admitted to the Transplant Service as necessary for preoperative evaluation, perioperative care, and postoperative complications and care. Fellows round daily as a team with staff and residents, visiting all transplant patients. Fellows and residents also round each morning to order immunosuppressants and to make management decisions in concert with the staff.
Outpatient care is an important part of the transplant patient management and follow-up. The Transplant Clinic is open daily for outpatient evaluation, treatment, and follow-up. Separate clinics in liver, pancreas, kidney, and vascular access are the responsibility of the fellow on each respective rotation. Fellows are expected to help with clinics when they are not in the operating room.
At UWHC, fellows are involved in a number of educational conferences. A weekly Transplant Speaker Conference is held on Monday afternoons. A weekly Transplant Indications Conference and monthly Transplant Business Meeting are held on Monday mornings. The fellows attend weekly Kidney and Liver Transplant Patient Selection Conferences on Mondays and Wednesdays and a monthly Pancreas Transplant Patient Selection Conference on Tuesday afternoons. Transplant Journal Club meets two to three times per month on Tuesday afternoons during the academic year. Surgical Grand Rounds take place Wednesday mornings.
Organs donated to the UWHC come from hospitals across Wisconsin and throughout the United States. They are procured by The University of Wisconsin Organ Procurement Organization which, along with the Fellow on each Procurement rotation, performs 120 to 140 procedures each year. Fellows on the Procurement rotation are responsible for perfusion and cold-storage preservation of donor organs. They become proficient in multi=organ procurement.
As a major research institution, The University of Wisconsin provides an excellent venue for laboratory and clinical investigations. Transplant fellows have the option of becoming involved in these research programs:
Faculty Member Research Topics
- Dr. Hans Sollinger: Gene therapy for diabetes, new drugs for transplantation, organ preservation
- Dr. William Burlingham: Cellular and molecular mechanisms of transplant rejection (especially humoral), chimerism,; tolerance, and soluble forms of HLA class I
- Dr. Anthony D’Alessandro: Organ preservation and multivisceral transplantation
- Dr. Jon Odorico: Stem cell biology, pancreas development, stem cell therapies for diabetes, islet transplantation, pancreas transplantation, pancreas allograft pathology
- Dr. John Pirsch: Immunosuppressive therapy and clinical trials
- Dr. Luis Fernandez: Islet transplantation, organ and tissue preservation
- Dr. David Foley: Identification of novel mechanisms and protective strategies against ischemia/reperfusion injury
- Dr. Joshua Mezrich: Transplant tolerance, organ response to injury
These efforts are supported by the department’s medical librarian and the university’s main medical library (Ebling Library, the University’s Health Sciences Library, is located in the Health Sciences Learning Center, adjacent to University of Wisconsin Hospital.) providing access to thousands of volumes of electronic, hard copy, and audio-visual resources. The program is also served by the department’s biostatisticians, publications specialists, and an extensive computerized database maintained by the UW Health Transplant Program.