Lung Transplant Fellowship Program

Overview

University of Florida offers a one-year advanced lung transplant fellowship. This program is designed for individuals who have completed a three-year fellowship in Pulmonary & Critical Care. This fellowship also provides training in Pulmonary Vascular Disease and Heart-Lung Transplant. Our lung transplant program has a multidisciplinary team that performs more than 50 lung transplants a year, and incorporates ex-vivo perfusion strategy to increase donor pool. Under the direct supervision and teaching from the medical and surgical faculty of the Heart-Lung & Lung Transplantation Program, the trainee will become UNOS certified physician by the end of the fellowship.

 

Requirements to become UNOS certified Lung Transplant Physician

  • Completing a Pulmonary & Critical Care Fellowship.

The trainee needs to maintain logs:

  • The fellow should have participated in the primary care of 15 or more lung and/or heart/lung transplant patients from the time of their transplant.
  • Should be involved in the management of 15 or more lung transplant recipients in their first three months of the post-operative course.
  • Have been an observer in 3 or more lung or heart/lung procurement procedures This must be supported by a recipient log.

 

Specific Objectives

  1. To review guidelines for recipient selection for lung transplantation.
  2. To understand outcomes following transplantation including survival and physiologic results.
  3. To understand the complications following lung transplantation.
  4. To demonstrate basic understanding in the management of lung transplant recipients in the immediate post-operative period in the ICU. This includes mechanical ventilator management, management of patients coming in cardiopulmonary bypass, management of VV ECMO.
  5. To have an understanding of the immunosuppresive medications used in lung transplantation.
  6. Demonstrate understanding of alternative therapies for end-stage lung diseases, such as medical and surgical therapy for pulmonary arterial hypertension.
  7. Demonstrate proficiency in flexible fiber-optic bronchoscopy, broncho-alveolar lavage, and trans-bronchial biopsy and other invasive procedures as indicated.
  8. To demonstrate basic understanding of VV and VA ECMO.

 

Core Lung Transplantation Curriculum

Each transplant fellow much complete the following core set of rotation blocks which are to last a minimum of 4 weeks each.

  • Inpatient Transplantation Block (3 months): During this block, the trainee is responsible for following on a daily basis an average of 6-8 patients that are to be assigned by the in patient attending every Monday during sign-out rounds. The trainee is expected to round during one whole weekend for each of the blocks along with the assigned faculty member.
  • Cardio – Thoracic Intensive Care Unit (3 months): During this block, the trainee will directly manage the immediate post-operative critical care issues of all those lung, heart/lung transplant recipients and ECMO under the supervision

During these blocks, the trainee will also go to the operating room to observe a minimum of 3 transplantation surgeries.

  • Bronchoscopy Suite Block (3 months): During this block, the trainee is responsible for performing procedures assigned to this suite. Trainee must complete a history and physical, as well as discuss the available imaging prior to each bronchoscopy. There are no weekend responsibilities during this block.

Electives (1 month):

  • Thoracic Pathology
  • Transplant Infectious Disease
  • Medical Intensive Care Unit
  • Thoracic Radiology
  • Outpatient (clinic) Elective: includes transplant, ILD, PH and CF clinics

Research (1 month):

  •  Outcome research or a quality improvement project.

The other three 4-weeks are vacation and CME.