Newcastle University

Aims

The module aims to provide the students with a basic insight into the major clinical issues and practices in solid organ transplantation below the diaphragm. The module focuses on the liver and kidney but will include information on islet cell and pancreas transplantation.

Outline Of Syllabus

The module will be delivered in a series of lectures with the first half concentrating on the liver and the second on the kidney and pancreas. There will be opportunities for discussion in the lectures and there will be some overlap between the two study areas - though every effort will be taken to keep this to a minimum and to use this where it is an important aspect of the module. Students will learn about the basic procedures as applied in clinical transplantation from preoperative considerations to post operative care and future developments.

The syllabus is in two parts:

Part One: Transplanation of the Liver

1. Acute & chronic liver failure & indications for transplantation
2. Assessment of patients for liver transplantation (including the importance of the multi-donor transplantation MTD and acceptable donor type)
3. Donor assessment and optimisation
4. Surgical aspects – retrieval technique, hepatectomy, anhepatic and implantation
5. Post-operative care
6. Immune suppression in liver transplantation
7. Early graft dysfunction
8. Late graft dysfucnction -
9. Long-term monitoring and care of the transplant recipient
10.New developments

Part Two: Transplantation of the Kidney & Transplantation of the Pancreas

1. Recipient selection and evaluation and management of the transplant waiting list
2. Assessment and care of patients who are difficult to transplant
3. Transplantation of ABO Blood type incompatible ABOi and highly sensitised patients (to include paired exchange)
4. Donor selection, assessment and management (cadaveric and live donors)
5. Surgery and early post-operative care – kidney
6. Surgery and early post-operative care – pancreas
7. Acute graft dysfunction – assessment, diagnosis and treatment
8. Chronic graft dysfunction – assessment, diagnosis and treatment
9. Long-term monitoring and care of the transplant recipient -
10.Islet cell transplantation

Teaching Rationale And Relationship

There is considerable amount of specialist knowledge in this module. Students will be be from various clinical backgrounds with different degrees and levels of prior knowledge the lecture series is set out in such a way to bring the students through the transplant process for both the liver and the kidney/pancreas sections. This format of delivery does allow for considerable discussion in the clincal setting but also enables an efficient delivery of the body of knowledge.

Assessment Rationale And Relationship

There are four assessments targetted at knowledge and understanding of the topic as taught as well as transferable skills within the profession. The first assessment tests: knowledge, understanding, communication, presentation and IT skills. The second assessment tests all of the above and team work. The third assessment tests the student's knowledge of the subject in a format familar to medical practicioners and used in real medicine - slides will include pictures of operations, scars, histology and blood results. The fourth assessment test the knowledge in a different format and tests the student's capacity to give written presentation as may be required in a professional or academic environment.

In the first assessment "Understanding the complexities related to choosing a potential donor for a recipient" students select 2 from 4 case studies of interesting / complex donors (kidney, liver, pancreas) - from case studies provided or persoanl experience and discuss factors relevant in the consideration of their suitability to act as donors giving their reasoning. We suggest that each case is submitted in the form of a power point presentation of a maximum of 5 slides.

In the second assessment "Journal Club" 4 recent journal articles will be circulated in advance of the meeting. At the time of the meeting the students will be allocated groups. Each group will be required to review one paper in the first hour and present it in 15 mins in the second hour of the session. Each student will be marked on presentation skills, interpretation of paper and team working skills. If a resit of this assessment is required, students will review a paper and present individually.

In the 3rd assessments "Picture Quiz" students will be shown slides. The slides will be presented in order, accompanied by an examination paper giving clinical details. The fourth assessment is a standard short essay (2000 words).