Welcome
Welcome to the Cleveland Clinic ASTS-accredited Abdominal Organ Transplantation and Hepatobiliary Surgery Fellowship.
Why should you choose Cleveland Clinic as your training institution? The answer is simple: what you learn early on in your career will shape forever your future!
We strongly believe that the ideal training program should provide the right mix of education, clinical volume, academic complexity, and innovation.
Our fellowship is an integrated program of abdominal organ transplantation and hepatobiliary surgery. Our high-volume liver and kidney transplant programs continue to grow every year. Our large hepatobiliary practice is the perfect environment to provide excellent oncologic and liver resection teaching, including the use of minimally-invasive (purely laparoscopic and robotic) techniques. We believe that liver transplantation and oncological liver surgery are one inseparable entity.
Every day we strive to innovate and increase access to transplantation by expanding the donor pool. This is why we created and clinically tested the first non-commercial ex-vivo normothermic liver preservation device in the nation. Our living donor program is one of the largest in the country. We recognize that this is not enough and we implemented strategies to increase the much safer transplant of left lobe living donor grafts with outstanding outcomes. We are one of few programs around the world to routinely perform purely laparoscopic living donor hepatectomies. The incorporation of machine perfusion with state-of-the-art viability assessment has allowed for increased organ utilization, particularly of extended criteria grafts. Our liver transplant oncology program has and continues to lead the way in this exciting field. The natural collaborations with our world-renowned cardiothoracic and lung transplant teams led to one of the most active program of simultaneous open heart surgeries and liver transplantation, and combined heart- and lung-liver transplants. Our kidney transplant program, under one of the most preeminent centers of excellence in urology and kidney medicine in the world, has a rich history of innovative practices, most notably in recent years having paved the way in the use of coronavirus-positive donors and robotic single-port kidney transplantation.
At Cleveland Clinic, we educate our fellows to become leaders in the field of transplantation by never accepting the status quo and by embracing relentless innovation. Our goal is to attract the finest candidates. We look forward to receiving your application!
Program Description
The Abdominal Transplant Surgery fellowship at Cleveland Clinic is an American Society of Transplant Surgeons (ASTS) accredited 2-year program offering comprehensive training in liver and kidney transplantation, and advanced hepatopancreatobiliary surgery. Appointment occurs through the SF Match scheme, alternating between 2 and 3 fellows each year. Our program boasts a substantial volume of transplantation activity, performing over 200 liver transplants and 300 kidney transplants each year.
Deceased donor organ transplantation
There is a significant amount of deceased donor activity in our region with ample opportunities for increased donation, including split-liver and DCD organ procurements. We provide a wealth of experience in the use of marginal/extended criteria organs including those obtained following donation after circulatory death (DCD). The program also provides pediatric liver transplantation services.
Living donor organ transplantation
The fellowship provides ample exposure to living donation for kidney and liver transplantation. The liver department has maintained an active living donation program since 2012. We are one of a handful of centers in North America to offer purely laparoscopic living liver donation, having performed all living donors laparoscopically since 2019. The minimally-invasive living donor nephrectomy program has also remained very active over the years.
Clinical innovation
The department consistently endeavors to be at the forefront of innovations in the field of transplantation. A substantial number of simultaneous organ transplants, including liver-kidney, liver-lung and liver-heart are performed, not to mention an appreciable volume of combined coronary revascularization - liver transplantation procedures. The program also provides liver transplantation as treatment for hilar cholangiocarcinoma, colorectal liver metastases, and metastatic neuroendocrine tumors, within the realm of specialized institutional protocols, which fellows get valuable exposure to.
Under the umbrella of approved research protocols, we also maintain an active ex-vivo machine-perfusion program for expanding the use of deceased donor livers. Our program is currently one of the largest users of ex-vivo normothermic machine perfusion in the country, which has allowed for a significant decrease in listing-to-transplant time and wait-list mortality.
Lastly, we are one of the few centers in the country to offer deceased donor uterine transplantation to women with absolute uterine factor infertility, and the first center in the nation to welcome a child following transplantation of a uterus from a deceased donor.
Hepatobiliary Surgery
The hepatobiliary surgery program averages approximately 150 cases annually with approximately 60% cases being performed laparoscopically, and the provision of appropriate, focused training. An increasing number of major hepatectomies are currently performed using a purely laparoscopic approach. Our center was one the first in the country to incorporate histotripsy for the treatment of unresectable liver tumors.
In-patient team structure
The liver in-patient service is heavily supported by a team a dedicated Critical Care Team and 8 physician assistants committed to pre- transplant care, ICU and post-operative care. Fellows gain intensive training in the perioperative management of transplant recipients, and patients recuperating following liver resections. The kidney service is led by the Department of Urology and Transplant Nephrology, and fellows rotate here for an approximate duration of 6 months in their 2 years of training.` There is flexibility built into this schedule to accommodate the needs of fellows who wish to have additional kidney experience. Fellows will have extensive exposure to deceased donor and living donor kidney transplantation, minimally-invasive donor nephrectomy, pancreas procurement and transplantation, and a variety of urological procedures.
There is a strong emphasis on academic activity with plenty of opportunities and guidance for the conduct of clinical projects towards presentations at national/international fora and publications. Fellows also lead bi-monthly in-house academics which include morbidity/mortality conferences, readmission meetings and journal club sessions.
In summary, we provide a fertile environment that enables the provision of high quality surgical training and the development of our fellows into competent multi-organ transplant surgeons and future leaders in the field of transplantation.
Faculty
Leadership
Alejandro Pita, MD
Fellowship Program Director
Venkatesh Krishnamurthy, MD
Fellowship Program Co-Director
Transplant Surgeons
Fellows and Alumni
Current Fellows
Second Year:
Esteban Calderon, MDJiro Kusakabe, MD
First Year:
Kumaran Shanmugarajah, MD, PhD
Glenn Wakam, MD
Alumni
Mazhar Khalil, MD
2021-2023
Associate Staff
Cleveland Clinic, OH
Eduardo Fernandes, MD
2021-2023
Associate Staff
Cleveland Clinic Florida, Weston, FL
Alejandro Pita, MD
2020-2022
Director, Abdominal Organ Transplantation and Hepatobiliary Surgery Fellowship
Cleveland Clinic, Cleveland, OH
Junshi Doi, MD
2019-2021
Staff
Red Cross Otsu Hospital, Otsu City, Japan
Yasser Fouda, MD
2019-2021
General Surgery Residency
Cleveland Clinic, Cleveland, OH
Morteza Tarokh, MD
2018-2020
General Surgery Residency
Hackensack University Medical Center, Hackensack, NJ
Laia Coromina Hernandez, MD
2018-2020
General Surgery Residency
University of Texas Southwestern, Dallas, TX
Giuseppe D’Amico, MD
2017-2019
Associate Staff
Cleveland Clinic, Cleveland, OH
Amit Nair, MD
2017-2019
Staff
University of Rochester, Rochester, NY
Maheshwaran Pitchiamuthu, MD
2016-2018
Staff
University of Oklahoma, Oklahoma City, OK
Kazunari Sasaki, MD
2016-2018
Staff
Stanford University, Palo Alto, CA
Kareem Eid, MD
2015-2017
Staff
Vanderbilt University Medical Center, Nashville, TN
Giuseppe Iuppa, MD
2015-2017
Staff
Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
Emmanouil Palaios, MD
2014-2016
Staff
Cleveland Clinic Florida, Weston, FL
Lisa Louwers, MD
2014-2016
Staff
University Hospitals, Cleveland, OH
Galal El-Gazzaz, MD
2013-2015
Staff
Broward Health, Broward, FL, USA
Mario Spaggiari, MD
2013-2015
Director, Abdominal Transplant Fellowship
University of Illinois, Chicago, IL, USA
Mustafa Nazzal, MD
2012-2014
Staff
Saint Louis University, Saint Louis, MO, USA
Norio Kawamura, MD
2012-2014
Staff
Hokkaido University, Sapporo, Japan
Melissa Gibbs, MD
2011-2013
Staff
Piedmont Hospital, Atlanta, GA, USA
Peter Hodgkinson, MD
2010-2012
Staff
Princess Alexandra Hospital, Queensland, Australia
Teresa Diago Uso, MD
2009-2012
Staff
Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
Masato Fujiki, MD, PhD
2009-2012
Director, Intestinal Transplant
Cleveland Clinic, Cleveland, OH, USA
Ganesh Gunasekaran, MD
2008-2010
Director, Hepatopancreatobiliary Surgery
The Mount Sinai Hospital, New York, NY, USA
Kenzo Hirose, MD
2006-2007
Director, General Surgery Residency Program
University of California, San Francisco, CA, USA
Cristiano Quintini, MD
2006-2007
Director, Digestive Disease Institute
Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
Koji Hashimoto, MD, PhD
2006-2008
Director, Liver Transplantation
Cleveland Clinic, Cleveland, OH, USA
Federico Aucejo, MD
2004-2006
Director, Liver Cancer Program
Cleveland Clinic, Cleveland, OH, USA
Naveed Ahmed, MD
2004-2006
Staff
Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
Upcoming fellows (2024-2026)
Dylan S. Isaacson, MD (Residency Northwestern University)Sami Shoucair, MD (Residency: Medstar Health Baltimore)
W. Kelly Wu, MD (Residency: Vanderbilt University)
Curriculum
Training and proficiency in deceased-donor organ procurement and back-table allograft preparation is emphasized during the first year of fellowship. Fellows spend nine months in the liver transplantation service during which time they also participate in the recipient hepatectomies and organ implantation, and patient management on liver transplant service and transplant ICU (with the support of a total of 8 physician assistants and 2 to 3 general surgery residents). Intensive training is also provided in the management of patients with end-stage organ liver failure. Hepatobiliary lists run concurrently and are accordingly managed. The remaining three months of the first year are spent in the kidney transplantation service where fellows are taught donor procurement and kidney transplantation. Emphasis is placed on surgical procedures related to kidney transplantation, including deceased donor organ recovery and laparoscopic living donor nephrectomy.
During the second year of fellowship, fellows gain further independence and versatility with abdominal organ transplantation, and increased exposure to living donor hepatectomy, split-liver procurement, and advanced hepatobiliary surgery including major resections for cancer and laparoscopic hepatectomies. In addition, training for ancillary procedures such as ablative liver interventions is provided. Similarly, fellows improve on their skillset within the realm of kidney/pancreas transplantation and become competent in deceased donor kidney transplantation whilst accumulating significant skills in laparoscopic kidney donation.
Training Modules
Each fellow will be required to complete ASTS educational on-line modules in liver, kidney, and pancreas transplantation during the 24 month fellowship period. This will be monitored by the Program Director and Coordinator.
Research
Scholarly activities in the form of clinical research are emphasized throughout the entire fellowship period. Fellows are encouraged to study a clinical question, present at scientific meetings and compose related manuscripts. The Cleveland Clinic provides numerous resources to assist Fellows in these pursuits, including access to a transplant specific database and biostatistical help.
Computer facilities include the EPIC Integrated Health Care System and the Electronic Database Interface for Transplantation (EDIT), which allows electronic access to medical records, laboratory data and outpatient records, with HIPAA compliance. Research inquiries are performed under IRB regulated. Fellows are assigned to a variety of clinical research and review projects during their fellowship, including the recent usage of machine perfusion technology for liver transplantation.
Clinical Conferences
Each month the fellows present cases for Morbidity and Mortality, and Readmissions Conferences to the whole department. The conference faculty moderator selects cases for presentation based on their teaching merit, and moderates the discussion. Fellows delve into the pertinent literature while focusing on clinical decision making, analyze reasons for any complications and discuss alternative management options. The main focus of the conference is towards improving clinical decision making and enhancing patient care.
Weekly selection committee meetings are held separately for liver and kidney transplant candidacy and fellows are expected to attend.
In addition, each subspecialty holds its own conferences (IBD, Liver Transplant, HPB, Intestinal Transplant, Pathology, Clinical Nutrition, etc.) These conferences are made available to all fellows that wish to attend them.
Seminars by Cleveland Clinic and visiting faculty are also delivered during Grand Rounds on a periodic basis. Presentations are on a broad range of topics, including clinical topic updates, world health, surgical history, etc.
Application Process
The program accepts two to three fellows annually, alternating each year. We participate in the SF Match. All applicants must apply through the SF Match Website. Candidates must have completed a medical school degree and completed or anticipate completion of a general surgery or urology residency program. Additional information on Transplant Surgery Fellowships can be located on the ASTS website.
Living in Cleveland
Cleveland is a Midwestern city with an upbeat atmosphere at low cost living. Cleveland is also home to the second largest theater district in the U.S. just below NYC, the Rock and Roll Hall of Fame, the Christmas Story House from the 1983 film as well as beautiful Lake Erie Beaches.
Lakefront and Sports. Our harbor area features the Rock and Roll Hall of Fame and Museum, the Great Lakes Science Center and Cleveland Clinic OMNIMAX Theater, and the Cleveland Browns football stadium. Cleveland also is home to Indians baseball and Cavaliers basketball.
Culture. Cleveland Clinic is located near University Circle, the center of the city's cultural and educational offerings. Around the Circle are Case Western Reserve University, Severance Hall (home of the world-renowned Cleveland Orchestra), the Cleveland Museum of Art, the Museum of Natural History and the Cleveland Botanical Garden, to name but a few.
Shopping. Just outside of Downtown Cleveland are shopping havens featuring a number of high-end retailers. Beachwood Place, La Place, Eton and Legacy Village are located on Cleveland's East Side; Crocker Park is located on Cleveland's West Side.
Parks and Recreation. The Cleveland Metroparks Zoo and Cedar Point amusement park offer fun for the entire family. The Metroparks that surround the city are perfect for golfing, hiking, horseback riding, cross-country skiing and ice skating.
Learn more about living and working in Cleveland and opportunities to engage young professionals.
Contact Us
Abdominal Organ Transplantation and Hepatobiliary Fellowship
Alejandro Pita, MD
Program Director, Transplant Surgery Fellowship
216.445.3570
PITAA@ccf.org
Janine Keough
Transplant Surgery Fellowship Coordinator
216.312.9206
keoughj@ccf.org
Graduate Medical Education
Main Office
1.800.323.9259
216.444.5690
Fax: 216.444.6112
