Team T

My last rotation is "Team T" which is the liver and kidney transplant service. Although at many hospitals, liver patients are seen by the general medicine service, here hepatology has a primary admitting service. We see all pre-transplant liver patients and post-transplant patients who have nonsurgical problems. We see all post-kidney transplant patients as well. It's a great place to learn about common liver diseases such as hepatitis, cirrhosis, spontaneous bacterial peritonitis, ascites, hepatic encephalopathy, and liver cancer. There are some oddball diseases such as primary sclerosing cholangitis and primary biliary cirrhosis as well. The patient acuity can be fairly high; sepsis, coagulopathy, and renal failure are common comorbid conditions, and patients bounce in and out of the intensive care unit. We also perform a lot of procedures such as paracenteses. It seems like it will be a pretty educational rotation.

The rotation is 6 days a week, admitting from 7:30-5pm. Anyone who comes in out of those hours is admitted to medicine overnight and transferred to us the following day. The census caps are slightly lower than medicine caps with 8 patients total rather than 10, a reflection of the time-consuming nature of procedures and pauci-ICU patients. The service is run by a hepatology fellow and attending. Although there are no overnight calls, it's considered a wards rotation. We'll see how this month goes.