The first year fellow is expected to become proficient in multi-organ procurement through hands-on training under the guidance of the transplant attending surgeons and the senior transplant fellow. Also in the first year, there is a graded introduction and responsibility for the liver recipient operation. The full realization of this procedure is not until the second year of the fellowship.

In the first year, fellows are also introduced to the procedure of right hepatic lobectomy for use in adult living donor liver transplantation. Because of the relative complexity of the procedure, the fellow will gradually assume a greater role in this operation during the second year.

Renal transplantation is introduced in the first year and by the end of the first twelve months the fellow should be quite proficient with this procedure and the management of potential complications. Fellows are immediately exposed to laparoscopic living donor nephrectomy and will also be exposed to pancreas procurement and transplantation.

Finally, the fellow is also involved in liver resections; biliary reconstructions, and tumor chemoembolizations.

Fellows also gain experience in the dedicated Transplant inpatient unit and ICU. The fellow is responsible for the guidance of the housestaff on the team, as well as the daily performance of such techniques as liver biopsy, paracentesis, thoracentesis, and insertion of hemodynamic monitoring devices such as Swan-Ganz catheters, central lines, and arterial lines.

The fellows work with the attending transplant surgeons, hepatologists and nephrologists and become proficient in the management of end stage liver and kidney disease, immunosuppressive medications, and in the recognition and treatment of transplant-associated complications.

Fellows also become proficient in the performance of liver and kidney biopsies. Attendance at the NYU Transplant outpatient pre- and post-transplant clinics is required to provide a broad-based exposure to all aspects of care for the transplant patient. This occurs in the dedicated outpatient Transplant offices.

Fellows are involved in the daily immunosuppressive decision-making process and are very familiar with all standard and newer generation immunosuppressive agents such as cyclosporine, tacrolimus, steroids, mycophenolate, rapamycin, thymoglobulin, OKT3, basiliximab, and daclizumab.

A significant amount of time is spent reviewing biopsies. A formal liver pathology conference is held every two weeks and a renal conference monthly to review results.