ABIM Tx Hepatology study plan

List the accepted indications for liver transplantation by disease category (cirrhosis with decompensation, HCC, acute liver failure, metabolic disease) and state the prognostic threshold that triggers referral for each

Differentiate absolute from relative contraindications, including active substance use, extrahepatic malignancy, cardiopulmonary disease, and psychosocial barriers, and justify each with a survival or resource argument

Calculate MELD 3.0 and MELD-Na by hand for at least 20 synthetic laboratory sets and identify which patients would gain or lose priority

Describe the exception-point pathways for HCC, cholangiocarcinoma, and metabolic disease and explain how waiting-list mortality is balanced against post-transplant benefit

Construct a pretransplant workup checklist covering cardiac risk stratification, pulmonary evaluation, infection screening, and nutrition assessment

Classify biliary complications by mechanism and timing: anastomotic stricture, non-anastomotic stricture, bile leak, choledocholithiasis, and sphincter dysfunction

Outline the presentation, duplex findings, and management sequence for hepatic artery thrombosis, portal vein thrombosis, and hepatic artery stenosis

Interpret the pattern of liver enzyme derangement (cholestatic versus hepatocellular, early versus late) to localize a complication to biliary, vascular, or parenchymal causes

Map the expected timeline of each major complication onto a post-transplant calendar from day 0 through year 5

Explain the role of endoscopic retrograde cholangiography versus percutaneous drainage versus surgical revision in biliary salvage

Compare the mechanisms of calcineurin inhibitors, mTOR inhibitors, antimetabolites, and corticosteroids, including the specific lymphocyte signaling step each drug interrupts

Describe induction strategies (basiliximab, alemtuzumab, thymoglobulin) and select an induction regimen for a patient with renal dysfunction or prior malignancy

Distinguish acute cellular rejection from chronic ductopenic rejection on clinical, biochemical, and histologic grounds

Apply Banff grading criteria to at least 15 biopsy descriptions and assign a rejection grade with the corresponding treatment escalation

Design a maintenance immunosuppression plan with trough targets for the first month, first year, and long term, including a renal-sparing conversion strategy

Build a prophylaxis schedule for cytomegalovirus, Pneumocystis jirovecii, hepatitis B, and fungal infection according to donor and recipient serostatus

Apply a renal-sparing immunosuppression algorithm to a recipient with rising creatinine and explain the calcineurin inhibitor versus mTOR inhibitor trade-offs

Recognize the clinical and imaging features of neurotoxicity, including calcineurin inhibitor tremor and posterior reversible encephalopathy syndrome, and state the immediate management step

Identify the risk factors, typical timing, and treatment approach for post-transplant lymphoproliferative disorder and non-melanoma skin cancer

Explain how immunosuppression is modified when infection and rejection coexist

Describe the intraoperative hemodynamic phases of liver transplantation and explain the pathophysiology and management of reperfusion syndrome

Interpret post-reperfusion coagulopathy, fibrinolysis, and transfusion thresholds using viscoelastic testing principles

Differentiate early allograft dysfunction from primary nonfunction and state the criteria and the decision point for retransplantation

Outline immediate postoperative ICU priorities: ventilation weaning, fluid and electrolyte management, immunosuppression initiation, and infection surveillance

Explain the perioperative considerations for a recipient with portopulmonary hypertension or hepatorenal syndrome

Construct a table of recurrent diseases (hepatitis C, hepatitis B, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, steatotic liver disease) with typical recurrence timing, diagnostic criteria, and prevention strategy

Differentiate recurrent disease from acute rejection and from de novo disease using histologic and serologic features on liver biopsy

List the features of de novo autoimmune hepatitis and de novo steatotic disease after transplant and identify the implicated immunosuppression factors

Explain the components of the liver biopsy report that predict graft survival, including fibrosis stage, ductopenia, and interface activity

Summarize long-term outcome drivers: graft failure, renal failure, cardiovascular events, and malignancy, with approximate risk magnitudes

Revisit the weakest two domains identified in the week 4 self-assessment and rewrite the underlying decision rules in your own words

Apply selection and recurrence concepts to at least 40 timed vignettes covering donor allocation, exception points, and post-transplant biopsy interpretation

Distinguish recurrent disease from rejection on at least 10 paired biopsy scenarios without reference material

Analyze missed questions by error type: knowledge gap, misread stem, or faulty reasoning

Complete a 100-question cumulative mock examination under timed conditions and review every item

Recite the MELD 3.0 calculation, Banff grading scheme, and immunosuppression trough targets from memory

Summarize the top 10 highest-yield management algorithms across all five domains in your own words

Identify any remaining content gap and schedule a targeted review before the examination date