Knowledge guides

LG17: Transplantation

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have in-depth knowledge of the topics listed under each clinical sciences heading.

For the statistical and epidemiological concepts listed, trainees should be able to describe the underlying rationale, the indications for using one test or method over another, and the calculations required to generate descriptive statistics.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis, management and outcomes.

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Transplantation immunology
  • Haematopoietic stem cell transplant (HSCT):
    • allogenic stem cell transplant (SCT) – principles of donor allocation, including immunological and non-immunological factors
    • defects of immune function and immunologic reconstitution following HSCT
    • predictors and immunologic mechanisms of stem cell non-engraftment
    • predictors and mechanisms of graft-versus-host disease
    • predictors and prophylaxis of post-transplant infection, including immune monitoring and vaccination
    • risks of specific transplant-associated lymphoid malignancies
    • standard immunological indications for allogeneic and autologous SCT
  • Solid organ transplantation (SOT):
    • common opportunistic infections in the post-transplant setting
    • defects of immune function post-transplant
    • diagnosis of post-transplant lymphoproliferative disorder
    • monitoring and prophylaxis of post-transplant infection, including vaccination
    • pathophysiology of hyperacute, acute, and chronic graft rejection
    • predictors and immunologic mechanisms of allograft rejection – direct versus indirect allorecognition
    • principles and typical agents used in allograft immunosuppression, and broad differences in specific organ allografts
    • principles of donor allocation, including:
      • ABO
      • avoidance of donor-specific human leukocyte antigens (HLA) antibodies
      • HLA matching
  • Indications for use of pooled immunoglobulin (intravenous immunoglobulin or subcutaneous immunoglobulin) in transplant recipients
  • Absolute contraindications to deceased solid organ donation
  • Australian and Aotearoa New Zealand national networks of umbilical cord blood banks and cord blood collection centres
  • Collaboration with associated specialities, including:
    • haematologists
    • infectious diseases physicians
    • treating transplant physicians
  • Immune-mediated reactions, such as immune reconstitution inflammatory syndrome
  • Recommendations for vaccination in transplant recipients:
    • post-transplant vaccinations and serological monitoring
    • pre-transplant vaccinations
    • vaccinations in B cell-depleting therapy
  • Role of DonateLife and Organ Donation New Zealand in deceased solid organ donation, including definition of cardiac death (DCD) and brain death (DBD), and relevant ethical issues
  • Roles of registries such as:
    • AusCord
    • CordBank (New Zealand)
    • Stem Cell Donors Australia
    • World Marrow Donor Association (WMDA)