Abdominal transplant fellowship: Is the current system stretching trainees thin?

A third of adults in the United States are sleep deprived and a significant number experience stress.1–3 Medical trainees and physicians experience higher rates of stress and burnout compared to the general population.4 In their paper, “Biophysiological Stress and Sleep Deprivation Among Abdominal Transplant Surgery Fellows,” Vaysburg et al. quantify stress and sleep deprivation among abdominal transplant fellows.5 They performed a cross-sectional observational feasibility study of 17 fellows over 28 days, using biophysical monitoring, surveys and Maslach Burnout Inventory. [...]there is evidence that while there is a learning curve to learning liver transplant, fellow involvement in the operation is safe with no difference in mortality or long-term outcomes.6 We feel it is prudent not to overstate the implications of the study on patient outcomes since this was not studied. Organ procurement centers can lead to optimally timed transplant operations, increased organ yield, and decreased transportation while favorably impacting patient outcomes.7 Normothermic machine perfusion has been used to preserve organs for up to 24 hours and ongoing research is studying viability testing and organ rehabilitation.8,9 Innovations in xenotransplantation and other novel organ sources may allow for more predictable operating times in the future.