Transplant Surgery

Specialty Champions

2024-2025: Suditi Chattopadhyay & Aksh Sharma

2025-2026: x

 

What is the field Transplant Surgery?

Transplant surgery is a highly specialised field focusing on the surgical replacement of failing organs through donor transplants. The Specialty requires a deep understanding of immunology, surgical precision, and post-operative care to ensure graft survival and long-term patient outcomes. Transplants can be both living and, with careful donor-recipient matching based on histocompatibility, blood group compatibility, and immunological markers to minimise rejection risks. Surgeons must be proficient in complex vascular anastomosis techniques, organ preservation methods, and managing perioperative complications such as graft dysfunction, infection, and rejection. There are also several ethical considerations surrounding organ allocation and donor consent which have to be managed, making it both technically and emotionally demanding. The specialty demands resilience, meticulous surgical skills, and a commitment to multidisciplinary teamwork with nephrologists, hepatologists, and immunologists to ensure optimal patient outcomes.

There are myriad subspecialties under transplant, such as Kidney, Liver, Pancreas, and even paediatric transplants. The common conditions that would require a transplant are End-stage renal disease (ESRD), Cirrhosis, and acute liver failure or Type 1 diabetes, which makes it extremely rewarding to have the opportunity to make a huge difference by getting patients off dialysis, curing diabetes, and improving their quality of life.

 

Why choose Transplant Surgery as a career?

Transplant surgery falls under the broad category of general surgery.
Subspecialties under general surgery:

  • Breast

  • Colorectal

  • Endocrine

  • Upper GI

  • Transplant

Given the vastness of the field, there is scope to develop interests in medical ethics and law, organ donation promotion, basic science, and research. Furthermore, the procedures are varied and complex: with surgeons potentially operating on multiple systems and extremely high impact on the patient with respect to quality of life. Moreover, it encourages close collaboration with experts from various fields!

 

What is the training pathway for Transplant Surgery?

1. After F2; one must complete 2 years of Core Surgical Training( CST) and finish the MRCS exam.

2. Then, Six years of General Surgery specialty training (ST3 to ST8). This will result in a Certificate of Completion of Training (CCT) in General Surgery, rather than transplant surgery. However, a specific exit exam in transplant is taken.
However, the London Deanery offers a Renal Transplant specific General Surgery training program, overseen by a Transplant Surgeon as Training Program Director (TPD)

During specialty training, trainees have to gain competence to Consultant level in elective and emergency General Surgery and Transplant Surgery. Typically this means the first four years of training might be structured as follows: 2 years of Gastrointestinal Surgery, 6 months of Vascular Surgery, and 18 months of Transplant surgery. This would however, vary by trainee and by region. The final two years of training would focus on developing the trainee’s transplant interest but must continue to include exposure to elective and emergency general surgery.

 

Learning resources for Transplant Surgery

Websites

To stay updated with general surgery and transplant news, keep an eye out on the websites below:

1. NHS Blood and Transplant (NHSBT) ( https://www.nhsbt.nhs.uk)

2. British Transplant Society (BTS) ( https://bts.org.uk)

3. The Association of Surgeons of Great Britain and Ireland (ASGBI) (https://www.asgbi.org.uk)

4. Association of Breast Surgery at BASO (ABS) (https://associationofbreastsurgery.org.uk)

5. Association of Coloproctology of Great Britain and Ireland (ACPGBI) (https://www.acpgbi.org.uk)

6. Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) (https://www.augis.org)

7. British Association of Endocrine Surgeons (BAES) (https://www.baes.info)

8. Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI) (https://www.alsgbi.org)

Textbooks

There are some books you can read for further detail about transplant surgery such as Transplantation at a Glance by Menna Clatworthy which provides an excellent introduction to transplantation, covering immunology, ethics, and surgical techniques. For a more comprehensive overview, Principles of Organ Transplantation by Peter J. Morris and Nizam Mamode is very good. For the specific subspeciality of renal transplants, Principles and Practice by Stuart J. Knechtle and Peter J. Morris is great and Liver Transplantation: Clinical Assessment and Management by Ernesto P. Molmenti and Kim M. Olthoff is perfect for liver transplantation.

Journals

In terms of academic literature, top journals in the field include the American Journal of Transplantation, Transplantation Proceedings, and Clinical Transplantation, all of which cover the latest advancements, and research in transplantation. Furthermore, The Royal College of Surgeons of England and the Royal College of Surgeons of Edinburgh  also host webinars and case discussions on transplant surgery.

General Tip

Lastly, in terms of learning, try and observe/scrub into as many surgeries as possible and read up on them beforehand so you can have better-informed learning!

 

Professional organisations relevant to Transplant Surgery

In the UK and Ireland, surgeons specialising in transplant surgery are affiliated with different royal colleges depending on their region of practice:

  • Royal College of Surgeons of England (RCS England)

  • Royal College of Surgeons of Edinburgh (RCSEd)

  • Royal College of Physicians and Surgeons of Glasgow (RCPs)

  • Royal College of Surgeons of Ireland (RCSI)

 Great professional resources include:

https://bts.org.uk/   - Link to the British Transplantation Society

 https://www.herricksociety.org.uk/training

Historically, transplant surgeons have come to the speciality from backgrounds in General Surgery, Vascular Surgery and Urology. Recent changes in surgical training have meant that the predominant route into transplant surgery is now via the General Surgery curriculum, with specific exit exams in transplantation. The Herrick society provides a great insight into the nature of the training pathways into the specialty.

 

NHS blood and Transplant: https://www.nhsbt.nhs.uk/organ-transplantation/

Council of Europe – European Directorate for the Quality of Medicines & Healthcare (EDQM)
The EDQM/Council of Europe publishes Newsletter Transplant, which gives international figures on organ, tissue and cell donation and transplantation.www.edqm.eu 

European Society for Organ Transplantation (ESOT)
The European society for transplant professionals.
www.esot.org

Eurotransplant

The organisation responsible for co-ordinating organ donation and allocation within many countries in Europe.
www.eurotransplant.org

International Society for Heart and Lung Transplantation
Professional society dedicated to the advancement of the science and treatment of end-stage heart and lung diseases. Provides information about membership, awards and meetings. www.ishlt.org

ITNS
The International Transplant Nurses Society. (Look into the involvement of other professions in the MDT)
www.itns.org

United Network for Organ Sharing (UNOS)- ( For those interested in practicing in the US or just curious!)
UNOS is the private, non-profit organisation that manages the U.S. organ transplant system.
www.unos.org

 

Events & opportunities

An upcoming opportunity in 2025:

RCPE Edinburgh: Solid Organ Transplant

Thursday 22 May 2025, 9:00 – 17:00

Online or in-person: Royal College of Physicians of Edinburgh, 11 Queen Street, Edinburgh EH2 1JQ

Overview

This event will feature a comprehensive programme addressing advancements and challenges in transplantation. Sessions include discussions on trends in organ donation, frailty assessment, machine perfusion, antibody-mediated rejection, and ethical issues like xenotransplantation. Esteemed speakers from renowned institutions worldwide will present cutting-edge research, fostering knowledge exchange in the field of solid organ transplantation.

Understanding current trends and innovations: Gain insights into the latest developments in solid organ transplantation, including trends in organ donation, advancements in machine perfusion technologies, and personalized immunosuppression techniques.

Enhancing clinical knowledge: Learn about key clinical challenges and solutions, such as frailty assessment for transplant candidates, antibody-mediated rejection management, and emerging therapies for post-transplant complications.

Exploring ethical and future perspectives: Explore critical ethical and regulatory considerations in xenotransplantation, as well as the potential future applications of technologies like extracorporeal photophoresis in transplant medicine.

 Other opportunities

  • Surgical Research Society (SRS) Annual Meeting 2025 – Great opportunity for abstract submission for medical students and trainees.

  •  ASiT Annual Conference

  •  MSc clinical anatomy @ Queens or Edinburgh – Great opportunity to take a year out from placement and really develop your anatomy knowledge!