Department of Medicine

Transplant Nephrology Fellowship Program

The Transplant Nephrology Program at IU School of Medicine, a one-year program accredited by the American Society of Transplantation, is designed to produce qualified transplant nephrologists in all aspects of transplant medicine, which includes understanding and applying innovating immunosuppression regimens and applying research experience and outcomes in the field of solid-organ transplantation. After completion of the 1 year Transplant Nephrology Fellowship, the fellow is eligible to become a UNOS designated Primary Transplant Medical Director of a Kidney or a Pancreas Transplant Program.

Clinical Settings

Fellows within the program train alongside faculty physicians at the IU Health Transplant Center, staffed by a multidisciplinary kidney transplant team that includes skilled transplant surgeons, nurse coordinators, anesthesiologists, pharmacologists, fellow nephrologists, interventional radiologists, pathologists, dieticians, social workers, psychologists, nursing staff, chaplains, administrative staff and financial counselors. Throughout training, fellows are primarily located at the IU Health University Hospital Organ Transplant Unit (Indianapolis) while also covering transplant-related issues, if needed, at other clinical sites on the IU School of Medicine—Indianapolis campus.

Transplant fellows share on-call responsibilities with the rotating nephrology fellow. They take calls from residents for any medical or renal problems. One faculty member is always on call and available to guide fellows, as needed.

Patient Care

Approximately 150-200 transplant kidney biopsies are performed every year on the IU School of Medicine—Indianapolis campus. Transplant fellows alternate with the rotating nephrology fellow for biopsies throughout the year to perform a minimum of 10 transplant biopsies. The transplant fellow is well-experienced and can independently perform transplant kidney biopsies mid-way through their fellowship year and generally perform more than 20 biopsies during the training period.

Transplant nephrology fellows learn to manage a minimum of 30 new patients with kidney and/or KP transplant and follow them for at least three months. Fellows also observe a minimum of three cadaveric and three living-donor kidney transplants and observe three organ harvests. Before completing this program, fellows conduct a minimum of 30 pre-transplant recipient evaluations and a minimum of 20 living-donor evaluations.

The fellow is involved in primary decision-making in all aspects of clinical care, including immunosuppression. Throughout the training period, fellows are extensively trained and become proficient in managing acute and chronic transplant rejections, transplant-related infectious diseases (including BK Virus Nephropathy and CMV), transplant-related malignancies (including PTLD and skin cancers), and immunosuppressive regimens, cardiovascular disease, diabetes, hypertension, metabolic bone disease, anemia and chronic allograft nephropathy—in both inpatient and outpatient settings.

Comprehensive clinical experience is also acquired in managing patients with both stable and complicated courses, who have received kidney-pancreas transplants, liver transplants with renal complications, and liver-kidney transplants.

IU Health is one of the few intestinal transplant programs in the country. Fellows are also exposed to manage all renal issues in such patients including combined intestinal-kidney transplant patients.

Teaching and Didactics

Our Transplant Curriculum is based on the recommended AST Transplant Nephrology Fellowship Accreditation Program. Transplant nephrology fellows are involved in teaching and guiding first-year categorical nephrology fellows.

Lectures are provided by basic and clinical scientists on immunology, pharmacology, obstetrics, metabolic bone disease and infectious disease topics along with sessions on post-operative and maintenance transplant care. In addition, fellows attend weekly acute transplant clinics and chronic kidney and kidney/pancreas transplant clinics as well as a biweekly pre-transplant donor and recipient evaluation clinic. In addition to lectures, fellows spend a minimum of 2 weeks in the HLA Immunology Lab.

Fellows are strongly encouraged to attend the AST Annual Fellows Symposium (Fall)and the AST Annual Meeting (Summer) during the fellowship year.

Research Experience

The transplant fellow is strongly encouraged to pursue clinical/translational research leading to at least one publication or national presentation. Research opportunities include prospective and retrospective outcomes analysis using a large institutional database, as well as using UNOS OPTN data. Fellows are also engaged in ongoing investigator initiated and multi-center prospective clinical trials.

 

Application Requirements

Applicants must have completed a two-year nephrology fellowship program and be board-eligible. A completed application and curriculum vita is required as well as a personal statement, and four letters of recommendation (one of which must be from the applicant’s fellowship director). Applicants must also submit a copy of medical school diploma and medical school transcripts and a copy of ECFMG certificate (if International Medical Graduate) and documentation of prior GME training in nephrology.

International applicants who completed their training in a non-ACGME or RCPSC accredited programs, may be considered on a case by case basis. Applicants must be a legal citizen of the United States, permanent resident or hold a J1 or H1b Visa.

Applications for the following year Transplant Nephrology Fellowship start July 1st. However applications are accepted throughout the year if the position is still open. Selected candidates are contacted by division staff to attend interviews conducted between the months of August and December.

 

Program Leadership

Asif A. Sharfuddin, MBBS

Asif A. Sharfuddin, MBBS

Associate Professor of Clinical Medicine