Transplant Services

Transplant Coverage 

Pager 9944 (if not working, call 6th floor)

Liver/Kidney/Pancreas:

Up to 1 year post transplant:  "First pass" goes to transplant surgery service. The daytime pager is 9944, after 7pm, transplant is covered by the ACS resident. If the transplant resident or ACS resident doesn't call back, on call transplant surgery attending is under smartweb as "1st MD inpt/outpt" upon searching "transplant" (this is the attending who is rounding on transplant surgery service for the week). After discussion with transplant surgery, patient may be admitted to transplant surgery or the patient's case may be referred to transplant hepatology or transplant nephrology depending on the surgeon's assessment of patient need and their current status (even if less than one year post transplant). 

After 1 year post transplant: First call goes to transplant hepatology (liver) or transplant nephrology (kidney and pancreas). If it's both kidney and liver transplant, call both services (depending on your assessment of needs, of course). 

Transplant Nephrology: Transplant nephrology is consult only service and may direct patient to either Transplant Surgery or Hospitalist service for admission if relevant depending on assessment. From 8a-5pm, please direct the first call or pages to the transplant nephrology attending (not the fellow or general nephrology attending), who will assist you (this is under smart web as "Nephrology- AM Transplant Attending"). After 5pm, please page the general nephrology fellow. Occasionally, there will be no nephrology fellow on call at night, in which case please page/call the on call PM transplant nephrology attending. 

Transplant Hepatology: Transplant hepatology is an admitting service (this service is the same service as the primary hepatology service), but depending on the patient's arrangement with the service (Involves many factors and is on a patient by patient basis. Often they will admit patients >3 months but <12 months post transplant), the patient may be directed to MOD for admission (i.e. you may be asked to place an MOD consult for admission). From 7a-5pm transplant hepatology is covered by an NP service (In Smartweb under "Hepatology Inpt Service- NP") including admission orders. After 5pm, consults should be directed to the on call GI fellow (the general GI fellow). After 5pm, if a patient is deemed to need admission to transplant hepatology, you will need to contact the MOD team to place admission orders under the hepatology service. After 5pm, please place both an MOD and Transplant Hepatology consult. Under the MOD consult order, please put "Please admit this patient for Transplant Hepatology overnight". Keep in mind that if hepatology tells you the patient can be admitted to MOD without transplant hepatology, you only need the Hospitalist admission order.  

For transplants at outside institutions, can discuss with transplant (up to 1 year post transplant) but it is often best to try to discuss with outside institution's responsible physician as these patients tend to be followed closely by outside hospital transplant surgeons.

Epic Consult Orders: 

Order names have been fixed and should be much more simple and logical than before:

For Liver, Pancreas, Kidney Transplant Surgery (route to the surgeons): "Transplant Surgery Consult (Liver, Pancreas, Kidney Transplant Surgery)". 

For Transplant Hepatology (route to GI medical team): "Transplant Hepatology Consult (Kidney and Pancreas)" and click "yes" on "is this for admission" question.

 For Transplant Nephrology (route to transplant nephrologists): "Transplant Nephrology Consult (Kidney and Pancreas)"