Approval of an inter-institutional training program for liver transplant surgeons, pathologists, and recipient transplant coordinators (RTC) was applied for by the Kumamoto University Hospital from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) in Japan in 2014. It was fortunately adopted, and operated with the financial support of MEXT in the first 5 years, and by Kumamoto University Hospital in the following 2 years. The program was operated by cooperation of six National Universities (Kumamoto, Nagasaki, Okayama, Kanazawa, Chiba, and Niigata) assisted by two high-volume centers, Kyoto University Hospital and the National Center for Child Health and Development. As the trainees, 20 surgeons, 8 pathologists and 8 RCTs were recruited among the 6 universities. The course for surgeons was a 3-year training consisting of on-site learning in the allied institutions, simulated surgery (organ harvesting and liver transplantation) using a pig, seminars by domestic and foreign experts, and on-demand web lectures. In the follow-up questionnaire of the surgical trainees, all positively evaluated the course for career advancement or improvement of surgical skills except one who quit to move to another field. The program motivated three surgical trainees to study abroad in the transplantation field. The one-year course for pathology in liver transplantation consisted of web discussion and diagnosis of clinical cases via a virtual slide system, and on-site training in Kyoto University which had accumulated many specimens. All the pathological trainees enjoyed the course because the program offered an extraordinary chance of clinical learning that was impossible for them to have only in their own institutions. It was difficult to recruit trainees for the RCT course because the nurses in the university hospitals were too busy to undergo the training as “extra” work. A full-time post for RCT is limited in the university hospitals, and it was achieved only for 2 trainees. However, the program could enlarge the reserve group for the next generation.
Liver transplantation involves only a small community of surgeons, clinical pathologists and nurses. This inter-institutional program not only assisted the improvement of skill and knowledge of each individual but also could create a wider community as the buffer for the reserve of the professionals and the system for easier exchange of information and problems. The present program could be the prototype of such systems in Japan, although there are so many points that should be improved. The established system with teaching materials stored in the web server can be passed on to a wider and permanent structure authorized by any academic society. We are hopeful that it can offer a platform of study and official confirmation of the ability of young professionals in the field of liver transplantation in Japan.
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