Program Director: Paul J. Gaglio, MD, FACP, AGAF, FAASLD
Message from the Program Director.
Thank you for your interest in the AASLD Transplant Hepatology Fellowship at Rutgers New Jersey Medical School.
We offer two pathways toward completing certification in Transplant Hepatology as defined by the ABIM.
1. Transplant hepatology training after gastroenterology fellowship (“fourth year”)
2. Dual certification training in transplant hepatology during your gastroenterology fellowship (formerly known as the “Pilot Program”). In this pathway, fellows receive transplant hepatology training during their three-year gastroenterology fellowship (total of three years for completion of gastroenterology and transplant hepatology fellowship training).
3. Upon completing either transplant hepatology training pathways and passing the gastroenterology board certification, fellows will be eligible to take the Transplant Hepatology Board Certification Exam jointly offered by the ABIM.
Trainees will gain knowledge and experience in diagnosing and managing patients with all varieties of liver disease including viral, alcoholic, metabolic, drug induced, and immune mediated diseases. The management of patients with complications of portal hypertension, end-stage liver disease, and hepatocellular carcinoma will be emphasized, as our Liver Transplantation program, the largest program in New Jersey attracts complex patients from New York, New Jersey, and Pennsylvania. Additional experience in managing patients with acute as well as acute on chronic liver failure, liver diseases associated with pregnancy, as well as other hepatologic emergencies will be achieved.
Our hepatology fellows gain expertise in evaluating prospective liver transplant candidates and determining if transplantation is required. We emphasize a multidisciplinary approach in the care of patients with end-stage liver disease in both the pre and post transplantation setting including an emphasis on psychosocial and ethical issues. As alcohol associated liver disease is now one of the most common indications for liver transplantation, our trainees will learn to work closely with our addiction medicine specialists to optimize care of these complex patients. Trainees will gain expertise in managing the immediate and long term complications associated with liver transplantation. They will acquire understanding of the surgical procedures performed both in donors and recipients. Optimizing immunosuppression, understanding drug interactions and post transplant prophylaxis, as well as evaluation and management of liver graft dysfunction will be emphasized. Fellows will maintain continuity of care both in the in-patient and out-patient setting providing an opportunity to learn about immediate and long term infectious, metabolic, cardiovascular, renal and other complications after liver transplant.
A key aspect of the hepatology fellowship is participation in the multi-disciplinary management of patients with complications of portal hypertension, as well as those with liver and other hepatobiliary cancers. The trainees will play a key role in our weekly radiology and tumor board meeting and gain understanding and expertise in the decision making processes related to patient management including defining optimal treatment pathways. They will gain knowledge and understanding of the indications, contraindications and expected outcomes of procedures like TIPS, PRTO, and endoscopic biliary procedures as well as management strategies for hepato-biliary malignancies including surgery, loco-regional therapies such as hepatic artery chemo-embolization, SBRT, Y-90, and radio frequency ablation.
In collaboration with our Advanced Endoscopy team, trainees will develop proficiency in understanding indications and expected outcomes related to endobiliary diagnostic and therapeutic procedures. Fellows will be given the opportunity to acquire experience related to endo-hepatology procedures in collaboration with our Advanced Endoscopy team In addition, hepatology fellows will develop proficiency in the indications, techniques and interpretations of liver biopsy. Interpretation of liver histology including liver allograft rejection will be an integral part of the training.
A key component of the transplant hepatology fellowship includes preparation for a career as academicians and clinical Investigators. All trainees will participate in teaching medical students, resident house staff, as well as visiting residents and gastroenterology fellows from outside programs. Trainees will have the opportunity to participate in ongoing research projects in the Division of Liver Disease and Transplant Hepatology. In addition, candidates will be encouraged to create an independent research project in the area of their interest in the field of hepatology, and will be required to complete a QAPI project. Trainees will receive mentorship provided by one or more faculty members to allow successful completion of their research projects and QAPI project.
The Hepatology and Liver Transplantation service at Rutgers Health New Jersey Medical School prioritizes management of patients in our Newark community, and also serves as a tertiary referral center. As a testament to our multi-disciplinary, integrated care model, our liver transplant program has continuously achieved some of the highest one and three year patient and graft survival rates in the United States. Hepatology fellows will have access to the vast array of resources available at Rutgers Health New Jersey Medical School as well as University Hospital.