Transplant Infectious Disease - UIHC/VAMC Solid Organ Transplantation and Hematopoietic Cell Transplant Service

At least one rotation block will be spent on the ID solid organ transplant service.

Goals and Objectives

By the end of this rotation, the fellow is expected to:

  • Establish an appropriate and logical work up of suspected infections in this immunocompromised population
  • Understand the net state of immunosuppression and its impact on patient predisposition to infectious complications over time
  • Understand the principles of and indications for immuno-prophylaxis and chemo-prophylaxis in this population
  • Understand the drug interactions, toxicities, and mechanisms of action of immunosuppressive agents
  • Perform an appropriate pre-transplant infectious diseases assessment
  • Demonstrate appropriate inpatient follow up care for this patient population
  • Communicate effectively with the transplant service, both verbally and in the medical record
  • Recognize common infection entities of the vulnerable patient and how they vary with time after treatment

Teaching Methods

Daily inpatient rounds with the ID Transplant attending: This includes review of the fellow’s work up, case presentation, clinical bedside examination, and review of all laboratory data and radiology tests. The fellow’s assessment of the problems and plans are critiqued with feedback on written documentation. Lecture’s during core curriculum conference.

Mix of Clinical Topics

  • There are on average about 15 inpatient and 3 SOT outpatient consults per month. These include consults from internal medicine, surgery, and outside referring physicians.
  • Patient Characteristics and types of clinical encounters, procedures and services:
  • Adult inpatients from a variety of socioeconomic levels and ethnic background are evaluated
  • Patients and diseases as above
  • Lumbar puncture
  • Wound assessment and exploration
  • Gram Stain

Reading/Learning Lists

  • Transplant Infectious Diseases Clinical Practice Guidelines, Am J Transplantation 4 (suppl 10):1-66, 2004
  • Principles and Practice of Infectious Disease, Mandell, et. al., 7th edition
  •  ID Grand Rounds
  • Journal club, fellow selected articles for review and discussion
  • Up-to-Date
  • Online access to numerous journals, MD Consult and textbooks through Hardin Library
  • Chicago Board Review DVD’s
  • Articles and reading materials as assigned by transplant service staff

Evaluation

Immediate feedback is given on each patient presentation. Written evaluation by the ID attending on service is given at the end of the rotation. The fellow provides evaluations of the rotation and attending physician to the Department.

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