Welcome to the Abdominal Organ Transplant Anesthesia (AOTA) Fellowship! Located at Toronto General Hospital, our program has been attracting professionals from around the globe who are eager to enhance their skills in abdominal organ transplantation since 2008.
We take immense pride in the diverse opportunities our one-year program offers, which includes extensive clinical exposure, research initiatives, educational sessions and access to the latest technology. Our goal is to support you in achieving your clinical and academic aspirations during your time at Toronto General Hospital. The AOTA Fellowship also fosters a vibrant community of anesthesiologists from various countries, ensuring that even after your fellowship concludes, you remain connected to our program. We hope this marks the beginning of a lasting relationship focused on learning and collaboration with the communities we serve.
Overview of the Institution and the Fellowship Program
Toronto General Hospital is a leading transplant center and boasts the largest transplant program in both Canada and North America. In 2023, we completed 197 kidney transplants, 202 liver transplants and 59 pancreas transplants. Our institution is also home to North America's largest Living Donor Liver Transplant program, performing around 80 of these transplants annually.
As such, the Abdominal Organ Transplant Anesthesia Fellowship provides a unique educational experience with significant exposure to kidney, liver, pancreas and multi-visceral transplants. Our staff possesses extensive expertise in handling complex transplant cases, utilizing state-of-the-art technology, including point-of-care coagulation testing for all procedures. We are eager to share our knowledge with fellows across various settings, including the operating room, pre-anesthesia assessments, pain management, teaching rounds and research.
Clinical Curriculum
The Abdominal Organ Transplantation Anesthesia Fellowship is exclusively based at Toronto General Hospital and it has a one-year total length of duration. Fellows will actively participate in the perioperative and intraoperative care of patients undergoing liver, kidney, kidney-pancreas and occasional multi-visceral transplants.
Another key aspect of this fellowship involves providing anesthetic care for patients undergoing major surgical oncology procedures related to hepatobiliary, pancreatic and general surgery.
Each day, a fellow is assigned to evaluate patients who are candidates for transplantation in the outpatient clinic. The fellow will assess the patients, discuss transplant considerations with the consulting clinic staff and collaboratively plan further investigations and optimization. The expanding living donor program for both liver and kidney recipients also involves fellows in screening and educating potential living-related donors.
Call Duties
Fellows will be on call specifically for liver transplants. Home call responsibilities for liver transplants are shared among four fellows, averaging four to five calls on weekdays and two-weekend calls each month.
Educational Curriculum
Listing Rounds
End-stage liver disease is intricate, requiring a multidisciplinary approach and tailored treatment planning that begins with assessing each patient's potential for candidacy and risk stratification. The anesthesia team plays a crucial role in selecting and preparing these patients for transplant surgery.
Liver Transplant Listing Rounds take place every Friday together with Liver Transplant Surgery and Clinical Hepatology. Fellows are encouraged to attend it approximately once a month to engage in discussions about perioperative patient management alongside the anesthesia staff.
Kidney transplant listing meetings occur later on Fridays, where anesthesia input is always valued. While these meetings are typically led by staff, fellows are encouraged to participate.
Learning Opportunities
Mandatory teaching rounds for fellows occur every Tuesday at 17:00 (5:00 pm), covering a wide range of topics curated by the TGH Anesthesia Staff and other specialists within the institution.
Since 2022, Dr. Carla Luzzi, along with transplant hepatologist Dr. Cynthia Tsien and transplant surgeon Dr. Chaya Shwartz, has established the Group for Advancing Education in Liver Transplantation. This group organizes educational events every three months, bringing together all three specialties to discuss and share vital knowledge in liver transplantation. These events aim to foster interaction among fellows from all specialties, creating a sense of community that extends beyond the program. Attendance at these sessions is expected from all fellows.
Transesophageal and Transthoracic Echocardiography
Weekly teaching sessions and reading rounds for transesophageal echocardiography are held on Wednesdays and Thursdays, respectively. All fellows are encouraged to attend. For more hands-on training in perioperative TEE, special arrangements will be made on a case-by-case basis.
