Sunday, December 11, 2011

Transplant

Posted by April at Sunday, December 11, 2011

I spent my fourth rotation on the surgical transplant service of the University of Michigan Medical Center. This service did many kidney transplants as well as liver and pancreas transplants.

A typical day started early at 0545 rounds. This rotation was unique in that it encompassed a variety of patients including pediatric critical care, adult critical care and floor status patients. The service also follows their patients after the transplant. So, there was some internal medicine therapeutics involved. For example, a patient with a history of a liver transplant was admitted for possible kidney stones. They were automatically admitted to the transplant service for management.

Although it might seem like transplant pharmacist are extremely specialized, they need to know a lot in the areas of infectious disease, critical care and internal medicine. I enjoyed this aspect of the rotation the most.

Another aspect of this rotation that I would like to mention are the protocols. This service is highly protocol driven. These specify who gets what medications based several patient characteristics. It is one of the pharmacists many jobs to see that the drug protocols are being followed. You might be surprised how often something gets missed!

I feel like there was a huge learning curve on this rotation. We only skimmed the surface in therapeutics class when it comes to immunosuppression. Not only do you have to know all the immunosuppressive medications but also why a physician should use one over the other.

Overall, I enjoyed this rotation because I really learned a lot from it.

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