Fellowship in Liver Transplant Clinical Pharmacology

Shirley M. Tsunoda, Pharm.D.

Fellowship Director
Shirley M. Tsunoda, Pharm.D.
Assistant Clinical Professor
UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences

Research Background

Dr. Tsunoda's research has focused on the pharmacokinetics and drug metabolism of intestinal and hepatic cytochrome P450s (CYPs), particularly CYP3A4 and transport proteins such as p-glycoprotein (P-gp). The highly variable nature of these enzymes and transport proteins among individuals poses challenges in the dosing and optimal use of substrate drugs. Understanding the genetic and environmental factors that influence the activity of these enzymes and transport proteins in the intestine and liver will help clinicians to individualize therapy.

Dr. Tsunoda's clinical area of expertise is in liver transplantation and liver disease. Transplant patients must take numerous concomitant medications in order to prevent rejection and combat side effects associated with the immunosuppressive medications. These patients are susceptible to numerous drug-drug interactions. Understanding the mechanisms of these interactions and finding strategies to ameliorate or minimize them are important clinically. In addition, understanding alterations of drug metabolism in liver disease is an important area of investigation towards optimizing the use of drugs in liver disease patients. Dr. Tsunoda's research program is interested in investigating the mechanisms of intestinal and hepatic metabolizing enzymes and transporters that may be altered in various forms of liver disease.

Fellowship Program Objectives:

Coursework and Training:
Laboratory techniques such as high performance liquid chromatography (HPLC), mass spectrometry (MS), polymerase chain reaction (PCR) and Western blotting Pharmacokinetics and drug metabolism Study design and statistical analysis Human subject research, guidelines, protection Clinical skills in managing liver transplant and liver disease patients Didactic clinical pharmacology coursework Teaching/presentation skills Writing/publication

Unique Skills the Fellow Will Acquire:

Potential to learn a diverse array of clinical and laboratory skills depending upon the experience and interest of the candidate. Laboratory techniques and clinical study design will be emphasized. Clinical work and teaching may also be encompassed. Fellowship will be tailored to the experience and interest of the candidate to achieve the goals of the fellowship.

Time Frame: Two years

The time devoted to research and clinical activities will be designed to complement the previous experiences of the candidate and accomplish the goals of the fellowship. Over the two-year training period, the candidate will spend 18 months at UCSD and 6 months with the pharmaceutical industry partner. This time allocation is flexible based upon your specific needs