Highlights - Transplant Institute - Surgical Fellowship Program

A high volume liver transplant experience is offered, including DBD, DCD and live donor transplants. Techniques learned include: piggyback, bicaval, portal bypass, dual organ, split, reduced size graft, domino and extended criteria graft.

• Our program has pioneered the use of HCV+, Hep B core +, and Covid + grafts.
• Our recipients include oncologic patients with: cholangiocarcinoma, metastatic colorectal carcinoma, and neuroendocrine tumors.
• Live donor evaluation is performed by an integrated cross specialty collaboration
• Live donor liver transplantation has been increasing over the last five years. We are currently performing the first part of the donor operation robotically
• The hepatobiliary surgery program performs approximately 120 cases per year. Many of these cases are performed using the Da Vinci robot. We also perform radiofrequency ablation and histotripsy.

Live donors are frequently evaluated using a virtual reality model of the organ for enhanced visualization. Additionally, fellows have access to a 3D printed model that allows for practicing the operations.

Fellows will learn how to perform:

• Both deceased and live donor kidney transplant
• Robotic live donor nephrectomy
• Both native and transplant nephrectomy

Fellows will have exposure to:

• Both open and robotic kidney transplantation
• Dual, en-block, peritransplant resection and stone removal
• Paired exchange, non directed and chain transplants

Did you know?
Ochnser performed Lousiana’s first international paired kidney donation.

We perform simultaneous kidney pancreas transplant, pancreas after kidney transplant, pancreas alone transplant, and pancreas retransplant. Operative experience includes both portal and systemic drainage techniques. Fellows will also have the opportunity to experience graft pancreatectomy, pancreas allograft biopsy, conversion from bladder to enteric drainage, and pancreatic pseudocyst management.

All of our graduates have surpassed the ASTS minimum guidelines for training in pancreas transplant.

• Our center performs both live and deceased pediatric liver and kidney transplant.
• We are supported by pediatric hepatology, nephrology and PICU teams.
• We are currently building a separate, stand-alone dedicated pediatric hospital.
• We are involved in international outreach programs in pediatric transplantation.

Fellows finish the fellowship very comfortable in organ selection and with all forms of organ procurement. Fellows perform between 75 and 100 multiorgan procurements during the two year period.

We use all modalities of organ preservation, including both abdominal and thoracic normothermic regional perfusion (NRP) techniques, as well as normothermic and hypothermic machine perfusion. By utilizing different perfusion techniques, we are able to assess organ viability and thus use extended criteria grafts.

During the procurement process:

• Patients are given UNET access, and every organ offer is reviewed with them.
• Fellows are supervised/coached on every procurement by a staff surgeon.
• The Louisiana Organ Procurement Agency (LOPA) has a full service procurement center approximately 35 miles away.

Fellows will learn how to perform DBD, DCD, Abdominal NRP, and Thoracic NRP. In addition to how to place liver and kidneys on the various perfusion systems. Ochnser owns its own perfusion systems.

There will be exposure to specialized backtable procedures or pediatric grafts, reduced sized grafts, pediatric en bloc kidneys, and unique arterial and vein reconstructions.

Several of the faculty have extensive hepatobiliary experience, The HPB program averages 100 cases annually with 50% being performed robotically and/or laparoscopically.

We are working on rounding out the exposure and case load to eventually achieve accreditation in Hepatobiliary cases.

We are routinely performing:

• robotic live donor nephrectomies
• robotic kidney transplantation
• elective robotic heptobiliary surgery