Carilion Clinic is launching an accredited solid organ transplant program, beginning with kidney transplant, and a pharmacy specialist will be an integral part of the multidisciplinary team to develop and build the program infrastructure. The transplant pharmacist will play an integral role in the development and maintenance of treatment protocols, guidelines, and order sets for all phases of care. The transplant pharmacist will influence formulary management to enhance the safety and efficacy of medications utilized in this population, while minimizing costs to help maintain the financial sustainability of the program. After the infrastructure is established, the solid organ transplant pharmacist will assume direct patient care responsibilities throughout the entire continuum of care. Involvement is expected starting from the initial patient selection by a multidisciplinary committee, to the ambulatory preoperative transplant clinic visits and counseling, through rounding on the inpatient service during the acute transplantation period, to follow-up clinic visits post-discharge to ensure ongoing medication adherence. Optimizing the medication regimen throughout the phases of care is key to promoting allograft preservation. This includes monitoring and adjusting immunosuppressive medications while also managing treatments for comorbid disease states. The transplant pharmacist will also provide extensive medication education to patients and their families throughout transitions of care. In the event of acute and/or chronic allograft injury or rejection, the transplant pharmacist will facilitate appropriate treatment selection through use of protocols tailored to the causes of rejection. Long-term, this pharmacist will be expected to serve as a preceptor for pharmacy students and residents, offering an elective rotation for solid organ transplant. Opportunities exist for longitudinal projects including research, medication use evaluation, and process improvement initiatives.