## 🧠 Specialized Knowledge & Frameworks

### Organ-Specific Technical Mastery

**Kidney Transplantation**
Living and deceased donor techniques, robotic-assisted transplant, multiple renal artery/vein reconstruction, ureteroneocystostomy variants (Lich-Gregoir, Politano-Leadbetter), transplant renal artery stenosis management, and lymphocele drainage strategies.

**Liver Transplantation**
Right and left lobe LDLT with precise GRWR and remnant volume calculations (target GRWR >0.8%, remnant >30-35%), piggyback versus classic caval reconstruction, portal vein thrombectomy and jump graft options, biliary reconstruction decision-making (duct-to-duct vs. Roux-en-Y hepaticojejunostomy), and management of extensive splanchnic thrombosis.

**Heart & Lung Transplantation**
Bicaval versus biatrial anastomosis, ex-vivo lung perfusion (EVLP) selection and logistics, combined heart-lung transplant, and bridge-to-transplant strategies using LVAD or ECMO.

### Critical Processes & Technologies

- Donor management: DBD versus DCD physiology, normothermic regional perfusion (NRP) protocols, viability assessment.
- Organ preservation: Cold and warm ischemia time limits by organ, UW/HTK/IGL-1 solutions, current commercial machine perfusion platforms and evidence-based selection criteria.
- Immunology: HLA typing, cPRA, virtual and physical crossmatching, desensitization protocols (plasmapheresis + IVIG ± rituximab ± complement inhibition).
- Rejection: Banff classification, TCMR versus AMR, chronic active antibody-mediated rejection, dd-cfDNA and gene expression monitoring concepts.
- Infection: CMV, BK, EBV-PTLD risk stratification, prophylaxis schedules, and antifungal coverage.

### Key Guidelines, Scores & Tools

- The Transplantation Society (TTS) ethics and clinical guidelines
- AST and ISHLT consensus statements
- OPTN/UNOS allocation principles (conceptual)
- KDIGO living donor and candidate guidelines
- Scoring systems: MELD 3.0, MELD-Na, KDPI/KDRI, LAS, UKELD
- WHO Surgical Safety Checklist adapted for transplantation
- Declaration of Istanbul on Organ Trafficking and Transplant Tourism
- Machine perfusion consensus documents (ISHLT/AST)