Abdominal Transplant/Nephrology APPE

Saint Luke's Hospital Abdominal Transplant/Nephrology Advanced Pharmacy Practice Experience (APPE) Rotation is a general medicine four-week learning experience at Saint Luke's Hospital. This learning experience will provide students exposure to the acute, inpatient management of kidney and/or liver transplant recipients and patients with end-stage kidney and/or liver disease. The pharmacist's role in this practice area is to encourage the best medication-related outcomes possible through taking part in multidisciplinary rounds, assisting with medication delivery to the unit, establishing and enforcing safe medication policies, and formulary. Pharmacists are often responsible for medication reconciliation, managing medication therapy via collaborative drug therapy management protocols. Additionally, the pharmacist provides education to patients, family members, physicians, medical students, nurses, and others. 

The area of practice is primarily on the H5N Renal Nursing Unit that currently has 20 patient beds, including renal and liver transplant recipients. In-Center Dialysis (ICD) is also located on the floor that includes eight chairs designated to provide hemodialysis for hospitalized patients. The team may include an attending nephrologist, transplant surgeon, advanced practice providers, and medical/surgical residents and students. Other disciplines on the team include the clinical pharmacist, pharmacy resident, transplant coordinator, transplant social worker, clinical dietitian, primary nurse, and dialysis liaison. Pharmacists work closely with the team to optimize medication therapies and provide the best care for each patient.

Potential Topics/Content

The goal is for the student to gain experience in the overall management of these patients through patient care experiences, literature review, and/or topic discussions, which may include:

  • Chronic Kidney Disease/End-Stage Renal Disease
  • Medication Considerations in Chronic Kidney Disease
  • Abdominal Transplant
  • Transplant Immunosuppression
  • Renal Replacement Therapies (IHD, CAPD, CCPD)
  • Anemia of Chronic Disease
  • Mineral Bone Disease
  • Transplant Rejection
  • Opportunistic Infections (CMV, BK, PJP)
  • Peritoneal Dialysis Related Peritonitis

Expectation of Learners

The pharmacy student should work toward assuming responsibility for overall safe and effective medication management for their assigned patients through identification and resolution of medication-related problems including, but not limited to, appropriate medications and dosing, recognition, reporting, and resolution of adverse drug events, drug interactions, and medication incidents, as well as monitoring of all therapies. 

A successful rotation for the student is highly dependent on the work ethic, motivation, and time management put forth by the student. Additionally, good communication skills are essential. The student is expected to conduct themselves professionally and maintain active communication with the preceptor to ensure all expectations and rotation objectives are met.

Acceptable attire includes solid color scrubs (matching top/bottom without logos) or business casual.

Student Activities

  • Attend patient care rounds with the Nephrology and Transplant Surgery Services team on H5N daily. 
  • Provide and document daily therapeutic drug monitoring services for their assigned patients receiving drugs requiring monitoring including, but not limited to, aminoglycosides, vancomycin, immunosuppression, anticoagulation, and total parenteral nutrition (TPN).
  • Provide and document education to new transplant patients and patients new to anticoagulation. 
  • Perform drug information searches and develop a final response for follow-up and process improvement as necessary. 
  • Complete readings as requested by the preceptor and participate in selected topic discussions with medical students and other staff. Additionally, the student will complete a clinical pearl, new medication overview, or medication update to the nephrology and/or transplant rounding team when such opportunities arise. 
  • Complete one or two rotation projects that will focus on improving patient care, drug utilization, or improving the competency or training of staff. 

Assessment of Performance 

The student will have a team of preceptors, including the assigned primary preceptor, who will provide frequent informal feedback on performance throughout the rotation. Formal assessment of student performance will be done utilizing the evaluation tool provided by the student’s school of pharmacy or additionally as determined by the preceptor. The student and preceptor will meet at the beginning of the rotation to identify any additional goals/objectives/projects to be accomplished during the rotation and negotiate appropriate timelines. Development of a rotation calendar is strongly encouraged within the first or second day of rotation. At a minimum, the preceptor shall provide formal verbal assessment of student’s performance at the midpoint of the rotation and a formal written and verbal evaluation will be provided within one week of the rotation’s completion or as required by the school of pharmacy. 


Breanna Clark, PharmD, BCTxP
  • School of pharmacy: University of Kansas
  • Residency training: PGY1—University of Utah; PGY2 Solid Organ Transplant—University of Utah
  • Specialty interests: Transplant, Infectious Diseases
  • Professional involvement: American Society of Transplantation
Lindsey DeZotell, PharmD, BCPS
  • School of pharmacy: South Dakota State University
  • Residency training: PGY1 Saint Luke’s Hospital of Kansas City
  • Professional involvement: Abdominal Transplant Selection Committee, Saint Luke’s Health System (SLHS) CRRT subcommittee, Kidney Transplant Outcomes Committee, SLHS Scheduling Committee
  • Health system, hospital, pharmacy, and residency committee involvement: American College of Clinical Pharmacy (ACCP)
  • Pharmacy awards, accolades: 2020 Missouri Society of Health-System Pharmacists Platform Presentation Research Recognition—Preceptor
Lauren Rice, PharmD, BCTxP
  • School of pharmacy: South Dakota State University
  • Residency training: PGY1—Methodist University Hospital; PGY2 Solid Organ Transplant —Nebraska Medicine
  • Specialty interests: abdominal solid organ transplant, ambulatory care, medication adherence
  • Professional involvement: American Society of Transplantation, Missouri Society of Health-System Pharmacists
Jill Robke, PharmD, BCPS, FASHP
  • School of pharmacy: University of Kansas
  • Specialty interests: Abdominal Transplant, Immunization, Work-life Balance, Preceptor Development
  • Health system, hospital, pharmacy, and residency committee involvement: Co-chair System Pharmacy Education Team (SPET)
  • Professional involvement: American Society of Health-System Pharmacists (ASHP), Kansas Council of Health-System Pharmacy (KCHP)
  • Pharmacy awards, accolades: 2008 Preceptor of the Year, University of Kansas School of Pharmacy; 2009 ASHP Fellow; 2004 Missouri Society of Health-System Pharmacists (MSHP) Pharmacist of the Year; 2003 ASHP Best Practices in Health-System Pharmacy Award—Improving Immunization Rates in At-risk Patients; 2002 Drug Topics’ Pharmacist of the Year; 2000 MSHP Research Award; 1999 ASHP Foundation Asthma Patient Care Traineeship; ASHP 1999 Immunization Advocacy Grant; 1997 MSHP Research Award