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The one-year fellowship in perioperative management of liver transplantation for the Anaesthesiologist will focus on 11 core competencies.

Pre-Operative Evaluation of Live Donors

  • Fellows will participate in live donor selection committee.
  • Fellows will see live donors in pre-operative clinic visits.

Pre-Operative Evaluation of Liver Transplant Recipients

  • Fellows will participate in live donor selection committee.
  • Fellows will see live donor recipients in pre-operative clinic visits.
  • Fellows will participate in cadaveric selection committee.
  • Fellows will round on acutely decompensated, inpatient liver recipient candidates.

Intraoperative Management of Live Donors

  • Fellows will manage at least five live donors intra-operatively.

Standard Intraoperative Management of Cadaveric Donors

  • Fellows will manage at least 45 cadaveric donors intra-operatively, initially supervising residents and then progressing to lone attending role.

Management of catastrophic events during liver transplantation

  • Fellows will learn the management of common catastrophic events during liver transplantation such as reperfusion syndrome, Takotsubo’s cardiomyopathy, pulmonary embolus, catastrophic hemorrhage, transfusion reaction and delayed graft function.

Management of Intraoperative Hemodialysis for the Liver Transplant Recipient

  • Fellows will learn indication, contraindication and management of intraoperative hemodialysis.
  • Fellows will be proficient in placement of intravenous hemodialysis access.

Management of Coagulopathy in the Liver Transplant Recipient

  • Fellows will use ROTEM and TEG for intraoperative blood component therapy administration.
  • Fellows will spend time in the blood bank learning both systems and management of component therapy.
  • Fellows will be able to choose between heterologous components and recombinant factors.

Post-operative care of the liver transplant recipient in the ICU

  • Fellows will learn ICU management of transplant recipients by a combination of interdisciplinary rounds and lectures from our intensivist faculty. Core concepts include hemodynamic management, transfusion in the ICU, nutrition, immune suppression, sedation protocols, physical therapy and occupational therapy.

Post-operative pain management for the liver donor and recipient

  • Fellows will work with the acute pain service to learn post-operative pain management. Specifics include multi-modal analgesia, TAP blocks, PCAs and pain busters.

Basic Perioperative Echocardiography

  • Fellows will participate in a year long lecture series with the focus of passing the written basic PTE exam.
  • Fellows will be expected to perform and interpret enough TEEs for basic perioperative TEE certification.

Quality Improvement/Research

  • Fellows will participate in at least one quality improvement project.
  • Fellows are encouraged to participate in a research project during their tenure.
  • Fellows are encourage to submit a poster presentation to the SCA.​