Transplant Infectious Diseases Fellowship

Solid organ transplant (SOT) recipients and hematopoietic stem cell transplant (HSCT) patients are susceptible to infectious complications following transplantation. These complications can lead to considerable morbidity and sometimes death.

The management of infectious diseases in SOT and HSCT patients requires knowledge, skills and clinical training. Physicians involved in the care of transplant patients should be able to provide appropriate diagnostic and therapeutic plans. Proper management of infectious diseases requires background knowledge of transplantation as well as awareness of drug interactions.

For the Transplant ID Fellowship, the focus is on patient care, training and research:

Patient care

Our main objective is to provide excellent patient-centered care in both inpatient and outpatient settings. The consultation service is available at three medical centres affiliated with London Health Sciences Centre (LHSC). There is an active Transplant Infectious Diseases Clinic in an outpatient setting. Our emphasis is on multidisciplinary teamwork including different transplant programs. In the future, we plan to extend our outpatient service specifically for pre-transplant screening, vaccination and travel issues.

Training

Training is the cornerstone of the Transplant ID Fellowship. We ensure that clinical training meets a high standard of care and that fellows will be well rounded with both clinical and research experience. Fellows will acquire the skills and expertise to work as a consultant with a transplant program.
The Division of Infectious Diseases also provides advanced training in the clinical care of HIV-infected patients. This is a good opportunity for fellows to compare the clinical issues and risk of infectious diseases in different subgroups of immunocompromised patients.

Research

During this fellowship, there is special emphasis on research in the field of transplant infectious diseases. In some collaborative projects, the fellows will have an opportunity to work with investigators at Western University, London, Canada.

Research projects will mainly focus on the following:

the relationship between infectious diseases and graft rejection in transplant recipients
effects of different infectious complications on graft survival
epidemiology of infectious diseases in SOT and HSCT recipients
randomized clinical trials evaluating the efficacy of diagnostic and therapeutic interventions
immunological mechanisms associated with the risk of infectious diseases in transplant recipients

Objectives include:

understand the pathophysiology of infectious diseases in immunocompromised patients including SOT and HSCT patients
appreciate the association between different immunosuppressive agents and the acquisition of infectious diseases
understand current screening strategies to reduce the risk of donor-derived infectious diseases
understand and manage the interactions between antimicrobial agents and immunosuppressive medications
understand the association between infectious diseases and graft outcome after transplantation

Evaluation includes:

Attendance and participation in teaching activities, rounds, journal clubs, and case presentations is mandatory. The quality of clinical learning during training will be monitored throughout the fellowship. Near the end of the two-year fellowship, a final report of research projects should be completed. All fellows will be encouraged to submit their interim and final findings to international congresses and meetings. The final assessment of clinical training will be based on the conclusive report prepared by the supervisor.