ABIM Tx Hepatology study guide
ABIM Tx Hepatology · Work through your exam, one topic at a time.
The ABIM Transplant Hepatology Certification Examination is the subspecialty certifying examination for physicians who already hold ABIM certification in gastroenterology and who have completed accredited transplant hepatology fellowship training. The program is jointly developed by the American Board of Internal Medicine and the American Board of Pediatrics; the examination is administered to candidates from both boards at the same time in the same testing centers, with ABIM responsible for administration. The ABIM Tx Hepatology study guide has 5 sections and about 1,522 words.
01Evaluation and Selection of Liver Transplant Candidates
Transplant evaluation answers three questions: is the liver disease severe enough that transplantation offers a survival benefit, is there a contraindication that cannot be modified, and can the patient survive surgery and adhere to lifelong care? Indications and timing.
326 words, about 2 min02Perioperative and Immediate Postoperative Care of the Liver Transplant Recipient
The anhepatic and reperfusion phases drive most early instability. Reperfusion syndrome - a fall in mean arterial pressure 30% for at least one minute, often with bradycardia, hyperkalemia, hypothermia, and acidosis - occurs in 10-30% of grafts and predicts early graft dysfunction.
305 words, about 2 min03Immunosuppression, Acute and Chronic Rejection, and Transplant Immunology
The liver is unusually tolerogenic - HLA matching is not required, and some recipients can eventually withdraw immunosuppression - but most need lifelong therapy. Standard maintenance is a calcineurin inhibitor (tacrolimus first-line) plus an antimetabolite (mycophenolate), with steroids tapered over weeks to months.
282 words, about 1 min04Post-Transplant Complications: Biliary, Vascular, Infectious, Renal, Neurologic, and Malignancy
Complications follow a clock. Early (<1 month): technical and surgical - primary nonfunction, hepatic artery thrombosis, portal vein thrombosis, biliary leak, hemorrhage, and bacterial or Candida infection.
298 words, about 1 min05Recurrent and De Novo Liver Disease, Histopathology, and Long-Term Outcomes
Recurrent disease is the leading cause of late graft loss for several indications. Hepatitis C recurred universally before direct-acting antivirals; treatment is now highly effective and should be given post-transplant.
311 words, about 2 min