UNC Transplant Nephrology Fellowship

The Nephrology Transplant Fellowship at the University of North Carolina Hospitals provides subspecialty clinical and research training in all aspects of kidney transplantation. The twelve month program accepts one fellow per year and has been accredited since 2005.

The UNC Kidney Center is committed to providing the Transplant Nephrology Fellow a mentored learning opportunity in preparation for a career in academic medicine focused on kidney transplantation.

Training opportunities include:

Clinical training

Fellows in transplant medicine gain extensive experience in the pre- and post-transplant management of kidney and/or pancreas transplant recipients. In the outpatient setting the renal transplant fellow is responsible for directing the evaluation process for all donors and recipients they evaluate, for interpreting their test results, and for attending weekly multidisciplinary selection conference where the fellow provides input regarding listing status decisions. Post-transplant outpatient care transitions from surgery to nephrology at one month following transplant.

The renal fellow, under the supervision of a transplant nephrology faculty member maintains primary decision making responsibility for these patients with regard to transplant immunosuppression, evaluation of allograft function, infection prophylaxis, and management of co-morbid medical conditions.

Inpatient rotations include 6 months of inpatient responsibility including performance of new consultations and follow-up consultative care for all kidney and pancreas recipients hospitalized at UNC. This includes consultative care of transplant recipients on other hospital services including the inpatient nephrology service. Duties include co-management with the surgery team of immunosuppression decisions in at least 30 new transplants per year.

The renal transplant fellow attends joint daily morning rounds with the transplant surgeon and transplant nephrology attending. All kidney and pancreas recipients in the hospital are discussed at these rounds. Clinical decisions include adjustment of immunosuppression, evaluation of allograft dysfunction, treatment of rejection or infectious complications, and advice regarding other medical conditions.

The transplant renal fellow also rotates in the histocompatibility laboratory at least 2 weeks per year.

Faculty includes:

Dr. Ronald J. Falk – Allan Brewster Distinguished Professor of Medicine, Director of Solid Organ Transplantation, Chairman, Department of Medicine, Director of UNC Kidney Center
Dr. Randy Detwiler – Director of Transplant Nephrology Fellowship Program, Medical Director of Kidney and Pancreas Transplantation
Dr. Karin True – Transplant nephrologist
Dr. Eddie Fuller – Transplant nephrologist
Dr. Pankaj Jawa – Assistant Professor of Medicine, General and Interventional Nephrology

From left: Ron Falk, MD, Randy Detwiler, MD, Karin True, MD, Eddie Fuller, MD, Pankaj Jawa, MD

Research Opportunities

Six months of the fellowship are dedicated to clinical electives and/or training in clinical research. The UNC Kidney Center has numerous mentors and resources to assist in the identification of a research project early in the fellowship. Though the emphasis of the fellowship is on clinical transplant training all fellows are expected to present results of their research at a national meeting and to ultimately publish their results.

Educational Opportunities

Educational activities include the following transplant specific conferences: daily teaching rounds with a transplant nephrology faculty member during all inpatient rotations, bi-monthly transplant education conference, transplant journal club, weekly kidney selection conference, weekly living donor and ABO incompatible transplant conference, weekly nephropathology conference including review of all transplant biopsies, and a lecture series overview of transplantation shared with the general nephrology fellows. Additional weekly general nephrology conferences are attended by the transplant fellow and include general nephrology journal club, nephrology grand rounds, nephrology fellowship lecture series, and medicine grand rounds.

Daily transplant nephrology rounds incorporate clinical responsibilities with directed didactic sessions.