North American Certification
Abdominal transplant surgery is certified in the United States through the Transplant Accreditation and Certification Council, not through an American Board of Medical Specialties member board. The assessment is purely oral, in two sessions, and one of those sessions is a defence of cases from your own practice. This guide covers both pathways, the fellowship requirements and how to prepare for a viva that examines you on your own operating.
The Transplant Accreditation and Certification Council accredits abdominal transplant surgery fellowship programmes and certifies the surgeons who complete them. It issues a certificate of completion to fellows finishing an accredited programme, and offers certification through two distinct pathways.
The Fellowship Certification Pathway is for surgeons who successfully completed a TACC-accredited abdominal transplant surgery fellowship from 2019 onwards. The Career Certification Pathway is for surgeons whose primary surgical career is abdominal transplant surgery and who completed an ASTS or TACC accredited fellowship between 1998 and 2018.
Both pathways are assessed by oral examination. Candidates on the career pathway must additionally have performed at least one abdominal transplant or donor procurement operation within the preceding two years.
Oral Examination
The second session is the one candidates underestimate. You are questioned on operations you actually performed, from a case log you submitted yourself, so weaknesses in your own decision-making cannot be revised around — they have to be understood and defended.
Kidney Transplantation
Recipient and donor selection, implantation technique, delayed graft function, and the differential diagnosis of early graft dysfunction.
Liver Transplantation
Allocation and scoring, technical variants including split and living donor grafts, and vascular and biliary complications.
Donation and Retrieval
Donation after brain death and after circulatory death, retrieval technique, machine perfusion and graft viability assessment.
Immunosuppression and Rejection
Induction and maintenance regimens, cellular and antibody-mediated rejection, and the infectious consequences of immunosuppression.
Pancreas and Multivisceral Transplantation
Indications, technical considerations, exocrine drainage and graft-specific complications.
Living Donation
Donor evaluation, the principle of leaving the better organ with the donor, ethics and long-term donor risk.
The oral examination is offered twice a year, in the autumn and the spring, with application and case-log submission well ahead of each sitting.
Dates, fees, case-log requirements and pathway eligibility change between cycles — confirm the current requirements with the ASTS Transplant Accreditation and Certification Council (asts.org) before applying.
Abdominal transplant surgery sits outside the American Board of Medical Specialties structure, so this certification is the profession’s own answer to the question of who is qualified. It is increasingly referenced by transplant programmes when appointing and when credentialing.
Preparing for it forces something unusually useful: you have to be able to defend your own case log out loud, including the cases that went badly. That is a more honest test of a transplant surgeon than any written paper could be.
By oral examination in two sessions, each assessed by two examiners. One session covers general transplant knowledge and organ-specific topics; the other discusses cases submitted by the candidate in the certification application. It is offered twice a year, in the autumn and the spring.
The Fellowship Certification Pathway is for surgeons who completed a TACC-accredited abdominal transplant surgery fellowship from 2019 onwards. The Career Certification Pathway is for those who completed an ASTS or TACC accredited fellowship between 1998 and 2018 and whose primary surgical career is in abdominal transplant surgery. Both require an active, unrestricted licence and a case log.
No less than twenty-four months, of which at least eighteen must be clinical training; the remaining six may be clinical or research-based. Candidates must have completed a surgical residency satisfying the requirements for certification by a recognised American board or its foreign equivalent.
Rehearse out loud, including your own submitted cases, because the second session is a defence of your personal practice. The SurgBoardsQ&A Exam Simulator runs a two-station transplant viva by module — kidney, liver, pancreas or retrieval — presenting cases step by step and following up whenever your reasoning is incomplete.
SurgBoardsQ&A provides 1,496 transplant practice questions covering kidney, liver and pancreas transplantation, donation and retrieval, immunosuppression and rejection, each with a full guideline-referenced explanation.
SurgBoardsQ&A provides 1,400+ practice questions mapped to the exam syllabus, each with a detailed explanation and guideline citation.
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50 questions free, no credit card required. Filter by board, topic, or difficulty. Explanations cite ESMO and NCCN.