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Transplant

Learn more about the duties, practice settings, typical workdays, and educational opportunities, as well as personal advice from pharmacists in this practice area.

What is transplant pharmacy?
Transplant pharmacy is a pharmacy specialty that focuses on the care of organ transplant candidates, recipients, and donors. Transplant pharmacists are recognized by the United Network for Organ Sharing and the Centers for Medicare and Medicaid Services as integral members of the multidisciplinary team required for program accreditation. They have many responsibilities including, but not limited to, pharmaceutical management in the pre-transplant, peri-transplant, and post-transplant phases; progressive collaborative practice; recipient and donor education; quality improvement; antimicrobial stewardship; pharmacogenomics; protocol development; student and resident education; and research. The role of a transplant pharmacist typically traverses both inpatient and outpatient practice settings, and covers a variety of complex disease states. Transplant pharmacists are essential transplant team members who improve the quality and safety of organ transplantation across the country.

Where does a transplant pharmacist work?
A transplant pharmacist can work in many practice settings, including inpatient hospitals, outpatient clinics, transplant program administration, specialty pharmacies, government agencies, pharmaceutical companies, and public-private partnerships. Because the scope of practice is very broad for transplant pharmacists, they are often equipped with many different skillsets that make them ideal candidates for unique positions in administrative, regulatory, and business environments. It is not uncommon for a transplant pharmacist to start in a traditional clinical role and advance to leadership positions within the health-system or in outside organizations. This is likely due to the skills that are acquired while working in a complex healthcare system with highly specialized medical interventions and socioeconomic needs.

What does a typical workday look like?
For a transplant pharmacist, a typical workday varies by the practice setting. For inpatient service, a transplant pharmacist will round with a multidisciplinary team on transplant recipients. The pharmacist is the medication expert and is expected to formulate a safe and effective medication regimen for each patient. Other responsibilities include reconciling all medications at transition points (i.e., upon admission and discharge) to ensure no medication errors occur. Patient monitoring and therapeutic drug monitoring are essential daily functions of an inpatient transplant pharmacist. Medication access and discharge coordination is also a high priority for a transplant pharmacist. Many programs employ pharmacy technicians that assist the pharmacist with prior authorizations, enrollment in patient assistance programs, and patients’ affordable access to medications at discharge.

In an outpatient setting, transplant pharmacists are responsible for the assessment of transplant candidates and donors, and the longitudinal monitoring of transplant recipients. For donors and patients under evaluation, the pharmacist is an essential component of the education and assessment of an individual’s appropriateness to continue in the process. Transplant pharmacists are able to identify medication issues and patient risk factors that can impact individuals’ ability to donate an organ or to be a transplant recipient. After transplant, the pharmacist provides medication recommendations and monitoring plans not only for transplant immunosuppression, but also for primary care and non-transplant concerns in the transplant recipient.

Transplant pharmacists routinely serve on many different committees as the pharmacy representative. These meetings include waitlisting meeting where patients are listed for organ transplant, quality improvement meetings, protocol development and data analysis, and transplant administration meetings.

The job is often done with a learner in tow. Most transplant pharmacists are preceptors for experiential rotations. Commitment to education is a cornerstone of this specialty.

What educational opportunities are available for pharmacists in this area?

  • Many pharmacists in this field complete work toward being BCPS certified. To find out more about board certification, you can visit the Board of Pharmacy Specialties Board Certification webpage.
  • Many national and international organizations host annual conferences in the field of transplantation.
  • ASHP has written guidelines on pharmacy services in solid organ transplantation and will provide board certification resources for certification and recertification.
  • Transplant pharmacists may seek additional certificates to improve their practice, such as Certified Diabetes Educator, pharmacist clinician licensure, etc.

How can I learn more about this career path?

  • The ASHP Section of Clinical Specialists and Scientists has an immunology and transplant network for transplant pharmacists. This includes programming at the Midyear Clinical Meeting and networking sessions to connect transplant pharmacists.
  • Students may also explore additional organizations focused solely on transplant such as The American Society of Transplantation Transplant Pharmacy Community of Practice which has opportunities for students to become involved and network with transplant pharmacists across the country.

Member Career Profiles

Amanda J. (Condon) Martinez, PharmD, BCPS
Advanced Clinical Pharmacist – Solid Organ Transplant
Medical City Dallas Hospital – Dallas, TX

What interested you in pharmacy and this career path?

“Pharmacy was a bit of a last minute decision for me. It wasn’t until my fourth year that I realized I made the right decision. I enjoyed my rotations working in a hospital setting and decided I wanted to pursue a residency. I wasn’t exposed to transplant until my PGY1, and by the third day of my transplant rotation, I was in love. Where else can you see so many sick patients be given a second chance at life? I quickly early committed to the PGY2 in transplant knowing this was the best fit.

Transplant takes everything you learned in school and puts it into one specialty. As a transplant pharmacist, you really are a ‘jack of all trades.’ It is a great specialty for people who like a lot of variety. I love that I can work both inpatient and outpatient, that I can take care of extremely complex and sick patients in the hospital, but then also help another patient consolidate their blood pressure and diabetes regimen in the clinic. I get a lot of satisfaction knowing we are able to make positive changes within our programs, and are treated like equals by the physicians and surgeons. I enjoy working on administrative projects such as protocol and quality improvement initiatives, which often improve how we practice transplant. We also take the education of learners very seriously and are invested in the growth of the next generation of pharmacists. Sharing the passion and excitement of a life-saving medical intervention is one of the best parts of the job. Transplant really is the best specialty for someone who craves variety and is dedicated to being lifelong learner. It’s rare when you can say that you truly love what you do, but for me I feel like I found my calling and the best career out there!”

What advice do you have for someone interested in this career field?

“Unfortunately, many colleges have limited or no transplant curriculum. This means most students’ first encounter with transplant is on rotation. If you’re interested in transplant, definitely join one of the transplant pharmacist organizations and try to get involved. We LOVE having students on our committees and have mentoring programs as well. Students give really great, fresh perspective and are key members of our groups. Reach out to a transplant pharmacist in your city to see if you can shadow them on the job. This will give you a firsthand account of what it’s like to be a transplant pharmacist. If you aren’t near a transplant center, reach out to me, and I am happy to chat with you and see if I can locate someone who is nearby or a good fit with your interests and questions. Transplant is a small field, but we really want to support students in gaining insight and access to this amazing specialty.”

 

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