Medical College of Virginia Hospitals & Physicians/VCU Health System now offers an American Society of Transplant Physicians Approved Transplant Nephrology Fellowship, in addition to our longstanding American Society of Transplant Surgeons Approved Transplant Surgery Fellowship within the Hume Lee Transplant Center at VCU.

Transplantation at the Medical College of Virginia Hospitals & Physicians/ VCU Health System has enjoyed a long history, dating back to 1957, when human kidney transplantation was pioneered here by the late Dr. David M. Hume, then Chief of Surgery. Since that time over 1800 renal transplants have been performed at this institution. Hepatic transplantation took place during a brief period in the late 1960’s, and resumed in earnest in 1984, with over 700 liver transplants having been performed at MCV/VCUHS since then. Clinical pancreatic transplantation began in 1994, with over 80 patients having received kidney-pancreas transplants since then.

The next opening for a Fellowship with the Transplant Center will be the 2007-2009 biennium. Our center participates in ASTS matching.

Fellowship training in transplantation began at MCV Hospitals & Physicians/ VCU Health System in 1969, with over 40 fellows receiving their training here in renal, and more recently hepatic transplantation. The American Society of Transplant Surgeons (ASTS) has approved the MCV/ VCUHS Renal Transplant Fellowship (continuously since 1981) for two years, and in 1996 we received ASTS accreditation for Liver Transplant (two years) training as well. The Fellowship is offered to one fully trained general surgeon each year.

The Clinical Transplant Program includes hepatic, renal and pancreatic transplantation, and is currently supervised by four transplant surgeons, a transplant nephrologists, a group of transplant hepatologists, and an immunologist. A geographically separate “Intermediate Care” Transplant Unit exists for the specialized care of renal, hepatic and pancreatic transplant recipients with the appropriately trained specialty nursing service available as well. The Program also includes a geographically separate multidisciplinary 10,000 sq. ft. Transplant Clinic located in the new Gateway Building run by nephrologists, hepatologists and surgeons, where all preoperative evaluations as well as postoperative long-term follow-ups are accomplished. Four Liver Transplant Nurse Coordinators, five Kidney Transplant Coordinators, a Nurse Practitioner, a Physician’s Assistant, a Transplant Pharmacist, and a Transplant Program Administrator round out the personnel intimately involved in the daily workings of the Program.

The Clinical Renal and Pancreatic Transplant Service currently is performing between 40 and 50 cadaveric renal transplants, 40 living related donor renal transplants, and 6-12 simultaneous kidney-pancreas transplants per year. An additional 400 or so major surgical cases are performed on dialysis and transplant patients. These include: 300 dialysis access procedures, surgery for portal hypertension and complex biliary problems, parathryoidectomy, preparatory surgical procedures in anticipation of renal transplantation (e.g. bi-nephrectomy, parietal cell vagotomy, colectomy, cholecystectomy, {laparoscopic and open}, etc.), hepatic resections for HCC (hepatocellular carcinoma), as well as a good number of general surgical procedures related to conditions resulting from the transplant itself (e.g. transplant renal artery stenosis, lymphocele, etc.), or complications arising in the dialysis and end stage liver disease patient populations. Transplant Fellowship Training at the VCU Health Care System has always been highly sought after because the training is, and always has been, a “hands-on” experience for the Fellow.
We are currently performing approximately 50-60 liver transplants/ year, including whole, “reduced” liver (or segmental), and living donor liver transplants. One quarter to one half of liver transplants each year are living donor adult-adult right lobe grafts.

Our results in renal transplantation have historically been well above the national average in terms of patient and graft survival. In the five year interval (1996-2000), patients receiving cadaveric renal transplantation at MCV/VCUHS enjoyed a 90% two year graft survival. Similarly, patient survival following liver transplantation at two years, for patients receiving OLT at MCV/VCUHS in the past four years in 88%. We think that these results accurately reflect the quality of our Transplant Program, and our ongoing commitment to meticulous patient care.

The Hume-Lee Transplant Center Transplant Program has one of the longest continuous transplant activities in the world; with renal transplant follow ups exceeding 25 years. These long surviving patients, in addition to the large on-going volume of evaluation, work-up, and postoperative care of the transplant recipients, provide the Transplant Fellow and the Surgical Residents (PGY1, PGY2, and PGY3) on the service with a broad range and depth of clinical experience in transplantation. The Transplant Fellow, once he/she gains the appropriate experience, is responsible for organ donor management and procurement, local as well as long distance, which typically involves multi-organ donation. The central and eastern Virginia catchment area (2.5 million population) generates between 70-90 “local” donors per year, including 25-30 “fly-outs”. In addition to clinical responsibilities, the Transplant Fellow has the opportunity to participate in clinical and basic experimental transplantation and transplant immunology. The Fellow will have the option to elect a one year research experience, in the laboratory under the direction of one Ph.D. and/or four M.D.’s in the areas of: histocompatibility, lymphocyte subsets, OKT3, HLA matching, serologic reactions to transplantation, newer immunosuppressive drugs, solid organ transplantation, infections in transplantation, hepatocyte and islet cell transplantation, transplantation tumor biology, the field of antigens and antibodies, whole liver and small bowel transplant, etc. Research activities are supported by extensive modern laboratory facilities, technicians, and local and federal grants. While Fellows are encouraged to spend a year supplementing their clinical experience with a strong research background, it is not mandatory. A Fellow may opt for a single year of clinical transplantation, or two years combined clinical/ research experience. While on clinical rotation, the Fellow will be strongly encouraged to conduct inquiries into a clinical research field pertaining to transplantation which would result in a presentation at a national meeting or in publication in a peer-reviewed journal.

The annual salary is commensurate with the Fellow’s previous level of training. Graduates of foreign medical schools must have passed their ECFMG requirements, including the Visa Qualifying Examination or the FMGEMS. Prospective fellowship applicants are encouraged strongly to visit the Medical College of Virginia Hospitals & Physicians of VCU Health System in order to meet the surgical and immunological preceptors involved, talk to the present Fellow, and thereby gain a true feeling for the quality of the Program.

Decisions as to the following year’s Transplant Fellow are generally made in the fall of the preceding 1-2 years and therefore interviews are encouraged to be arranged as early as possible.

For further information, please contact:

Marc P. Posner, M.D.
Professor and Chairman
Division of Transplantation Surgery
Virginia Commonwealth University Health System
Richmond, VA 23298
Phone: (804) 828-9298
Email: mposner@hsc.vcu.edu