7:00 a.m.

Registration and Continental Breakfast — Exhibits Open

7:45 a.m.

Welcome and Opening Remarks, Abhinav Humar, MD, University of Pittsburgh Medical Center, and Sarah Chart, OptumHealth Education

8:00 a.m.

Transplantation: Current Trends and Future Horizon, Abhinav Humar, MD (session not accredited)

8:15–10:15 a.m.

Liver Transplantation Panel Discussion
Liver transplantation has proven to be a viable treatment option for appropriately selected adults and children with acute and chronic liver disease. The demand for liver transplantation increases every year, resulting in longer waiting times for an organ and increased pretransplantation mortality. Liver transplantation outcomes depend on donor factors and the disease stage of the recipient. This panel discussion will explore the variables that impact mortality for those on the liver transplant waitlist, the use of live-donor livers for transplant, medical approaches to optimize outcomes and the importance of a multidisciplinary team to optimize outcomes for this patient population.

Learning Objectives:

1. Identify variables that impact mortality for patients on the liver transplant waitlist and approaches to the medical optimization of these pretransplant recipients.
2. Discuss the reasoning behind recent changes to the United Network for Organ Sharing (UNOS) policy that will somewhat limit access to transplant for patients with hepatocellular carcinoma (HCC).
3. Recognize the common indications for pediatric liver transplantation.
4. State the increasing number of rare genetic and metabolic diseases that are treatable with liver transplantation.
5. Review surgical options in portal hypertension for children with extrahepatic portal venous obstruction or liver disease with portal hypertensive bleeding.
6. Discuss which patients are best suited to receive a live-donor liver transplant.
7. Identify the importance of multidisciplinary team management as a key to a successful posttransplant outcome.

Medical Optimization of the Pretransplant Patient — Improving Survival on the Liver Transplantation Waitlist, Kapil Chopra, MD

Liver Transplantation for Hepatocellular Carcinoma (HCC): Evolving Algorithm in the Model for End-Stage Liver Disease (MELD) Era, Christopher Hughes, MD, FACS

Pediatric Liver Transplantation: Indications and Evaluation, Robert Squires, MD

Understanding the Different Surgical Options for the Child with Liver Disease, George Mazariegos, MD

Live-Donor Liver Transplant for Adult and Pediatric Recipients, Abhinav Humar, MD

Panel Q&A: Liver Transplantation

10:15 a.m.

Break — Exhibits Open

10:30–11:45 a.m.

Intestinal Rehabilitation and Transplantation Panel Discussion
Long-term survival of irreversible intestinal failure has become a reality due to a greater understanding of the complications of long-term parenteral nutrition. With this we face new challenges in the care of the patient with chronic intestinal failure, including the ability to successfully navigate the management of these complex patients, which is critical to both their nontransplant and transplant success. This panel discussion will explore key advances in intestinal failure therapy, identify the most appropriate candidate for intestinal transplant, review the most recent nontransplant medical and surgical options for patients with short bowel syndrome, and highlight current long-term outcomes in adult and pediatric intestinal transplant patients.

Learning Objectives:

1. State current long-term outcomes in adult and pediatric intestinal transplantation.
2. Review the most recent nontransplant medical and surgical options for patients with short bowel syndrome.
3. Identify the most appropriate candidate for intestinal or multivisceral transplantation.
4. Discuss key advances in intestinal failure therapy that have enabled long-term survivability.
5. Describe how successful management can provide both transplant and nontransplant options in ensuring a higher quality of life.

Management of the Challenging Pediatric Intestinal Failure Patient, Jeffrey Rudolph, MD

Intestinal Rehabilitation and Transplant: State-of-the-Art Solutions for Complex Intestinal Problems, Ruy Cruz, MD, PhD

Challenges in Long-term Graft Outcome and Transplant Surveillance, George Mazariegos, MD

Panel Q & A: Intestinal Rehabilitation and Transplantation

11:45 a.m.

Lunch (provided) — Exhibits Open

1:00–3:00 p.m.

Kidney Transplantation Panel Discussion
Kidney transplantation represents the best therapeutic option for end-stage renal disease (ESRD) in adults and pediatrics. In the United States, over 100,000 patients with ESRD are awaiting a kidney transplant. Mortality on the waitlist is high and is directly proportional to time spent waiting. Highly sensitized patients, as well as certain blood groups and age groups were at a disadvantage with the previous allocation system. UNOS recognized these shortcomings of the existing allocation system and proposed a new system that went into effect in December 2014.

This panel discussion will review the impact of the new kidney allocation system on wait times and patient outcomes; the benefits and challenges with pediatric and adult kidney transplantation, including the potential complications associated with lifelong immunosuppression; and factors that may impact long-term survival, including the presence of low-grade rejection that is not clinically evident. The panel will also discuss deterioration of renal function following nonrenal solid organ transplant (NRSOT), which has been associated as an independent predictor of mortality.

Learning Objectives:

1. State the role of immunosuppression in preventing acute and chronic rejection in renal transplant recipients.
2. Assess the limitations of combination immunosuppressive agents and some of the nonimmunosuppressive side effects of immunosuppressive agents.
3. Recognize how to optimally manage transplant patients by preserving allograft function.
4. Identify the impact of the new kidney allocation system on wait times and patient outcomes.
5. Explain the clinical utility of surveillance biopsies.
6. Identify the challenges of monitoring renal function in NRSOT, and review outcomes of kidney transplantation in this population.
7. Determine the preoperative evaluation of potential pediatric kidney transplant recipients and the challenges faced by very young kidney transplant recipients.

Immunosuppression in Renal Transplant: Past and Present, Sundaram Hariharan, MD

The Effect of New Allocation System on Kidney Transplant Outcomes, Wait Times and How We Care for Patients, Puneet Sood, MD, MPH

Surveillance Biopsies in the Early Detection of Cell-mediated and Antibody-mediated Rejection in Kidney Transplantation, Rajil Mehta, MD

Pediatric Kidney Transplant after Non-Renal Solid Organ Transplant (NRSOT), Christina Nguyen, MD

Challenges in Pediatric Kidney Transplant, Abhinav Humar, MD

Panel Q & A: Kidney Transplantation

3:00 p.m.

Break — Exhibits Open

3:15–4:15 p.m.

Pancreas Transplantation Panel Discussion
Pancreas transplantation continues to evolve as a strategy in the management of diabetes mellitus. A variety of factors, including advances in surgical techniques, immunosuppression, graft-preservation techniques, methods of diagnosis, treatment of rejection, and management of common posttransplant complications, have led to significant improvements in graft and patient survival. A total pancreatectomy- islet autotransplantation (TP-IAT) has been increasingly utilized for the management of chronic pancreatitis (CP) and has met with early success. This panel discussion will review the different indications, risks, benefits, and the importance of patient assessment and selection to optimize outcomes in pancreas transplantation, as well as describe the challenges and therapeutic options for patients with recurrent acute or chronic pancreatitis that affects their quality of life.

Learning Objectives:

1. Describe how patient assessment and selection optimizes outcomes for pancreas transplant.
2. Identify future challenges and opportunities to improve total TP-IAT outcomes.
3. Identify indications, contraindications, and immediate and long-term benefits of/outcomes for pancreas transplantation.

Pancreas Transplant: Who Are the Ideal Candidates? Amit Tevar, MD

Total Pancreatectomy with Auto-islet Transplant — A Curative Option for Chronic Pancreatitis, Martin Wijkstrom, MD

Panel Q & A: Pancreas Transplantation

4:15 p.m.

Closing Remarks/Adjourn
 

7:00 a.m.

Registration and Continental Breakfast — Exhibits Open

7:45 a.m.

Welcome and Opening Remarks

8:00–9:45 a.m.

Blood/Marrow Transplantation (BMT) Panel Discussion
BMT can oftentimes serve as definitive curative therapy for a wide variety of diseases. In a number of genetic, hematologic, immunologic, metabolic, and oncologic disorders, BMT can be a potentially life-saving procedure. This panel discussion will explore the potential benefits and limitations of allogeneic and autologous transplantation. It will also address various stem cell sources, the role of human leukocyte antigen (HLA) typing, donor procurement, and peritransplant supportive care, as well as novel approaches to transplant aimed at improving outcomes.

Learning Objectives:

1. Identify the various stem cell sources and obstacles to successful donor procurement.
2. Review the indications and outcomes in adult and pediatric patients undergoing blood/marrow transplantation.
3. Describe the principles that drive reduced-intensity transplantation for nonmalignant disorders of immunity and metabolism.

Matched Sibling, Living-Unrelated-Donor and Banked-Unrelated-Cord-Blood Donor Grafts: Outcomes Comparison, Randy Windreich, MD

Superior Survival and Quality of Life after Reduced-intensity Transplantation for Nonmalignant Disorders of Immunity and Metabolism, Mark Vander Lugt, MD

Allogeneic Hematopoietic Stem Cell Transplantation (SCT): A Bench-to-Bedside Story, Warren Shlomchik, MD

SCT — Pushing the Boundaries, Mounzer Agha, MD

Panel Q & A: Blood/Marrow Transplantation

9:45 a.m.

Break — Exhibits Open

10:00–11:30 a.m.

Innovations and New Frontiers in Transplantation Panel Discussion
Transplantation is totally dependent on the supply of viable organs for implantation. There is a marked imbalance between the numbers of available organs and potential recipients. Due to this severe shortage of donors, there is increasing interest in utilizing organs from “donors after cardiac death” (DCD). Options to utilize machine perfusion as a way to enhance organ preservation and increase the donor pool are now available.

Generally with solid organ transplantation, a lifelong burden of immunosuppression with many accompanying toxic effects occur, including renal dysfunction, opportunistic infection, and malignancy.

During this panel discussion, recently developed technologies and their applications for DCD will be addressed. Also discussed will be ways to predict acute cellular rejection that can assist in personalized immunosuppression management and reduce side effects after transplantation, along with what’s new in transplant-tolerance protocols.

Learning Objectives:

1. State the options to utilize machine perfusion as a way to enhance organ preservation and increase the donor pool.
2. Discuss recently developed technologies with machine perfusion and hemoglobin oxygen carrier solutions, and their applications for DCD donors.
3. Recognize the clinical significance for testing complement-binding and non-complement-binding HLA antibodies and the contribution of determining immunoglobulin G (IgG) subtypes as related to transplant outcomes.
4. Explain the current status and outcomes of immunosuppression withdrawal following liver transplant.
5. Discuss what’s new in tolerance protocols.

Organ Perfusion and Extending Use of Deceased Donor Livers, Paulo Fontes, MD

The Status of Tissue Typing and Transplant Outcomes, Adrianna Zeevi, PhD

Immunosuppression Management with Non-Invasive Testing, Rakesh Sindhi, MD

What’s New in Tolerance Protocols, Sundaram Hariharan, MD

Panel Q & A: Innovations and New Frontiers in Transplantation

11:30 a.m.

Lunch (provided) — Exhibits Open

12:45–2:45 p.m.

Adult and Pediatric Heart Transplantation Panel Discussion
The prevalence of patients living with advanced heart failure continues to rise, and the continued shortage of donor organs has resulted in increased use of ventricular assist devices (VADs) as destination therapy. The chronic management of patients with VADs is becoming an area of greater focus to not only improve quality of life, but also to mitigate against some of the most common adverse events such as stroke, bleeding, and thrombosis. Risk factors for stroke and bleeding with VADs will be addressed, as well as the impact outpatient management strategies have on these adverse events.

There are also a significant number of children who require heart transplantation — often those with congenital heart disease — that are broadly sensitized. Such patients are at increased risk of life-threatening rejection if transplanted across a positive donor-specific crossmatch. Strategies on how to manage these complex patients will be discussed.

Malignancy is a common cause of morbidity and mortality in patients after cardiac transplantation. The medications commonly used to prevent rejection and prolong life are a significant risk factor for the development of cancer. During this panel discussion, you will also learn how immunosuppression is related to cancer, strategies to minimize cancer risk, and how to manage a heart-transplant recipient with cancer.

Learning Objectives:

1. Discuss the impact of pulmonary hypertension on various aspects of solid organ transplant and the use and pitfalls of pulmonary arterial hypertension- (PAH)-targeted therapies in these patients.
2. Recognize risk factors for stroke and bleeding with left-ventricular assist devices (LVADs) and the impact of outpatient management strategies on these adverse events.
3. Describe the effects of immunosuppression on the development of posttransplant malignancies.
4. Identify strategies to minimize cancer risk after heart transplantation.
5. State the indications and optimal timing for ventricular device placement in children with refractory heart failure.
6. Review the current survival for patients bridged to heart transplantation using pediatric VADs.
7. Identify pre- and posttransplant risks and causes of sensitization in pediatric heart transplant candidates, and explain the use of antibody-mediated rejection as a treatment.

The Impact of Pulmonary Hypertension across the Spectrum of Solid Organ Transplantation, Michael Mathier, MD

Meeting the Challenges of Medical Management of the LVAD Patient: Hypertension and Anticoagulation, Jeffrey Teuteberg, MD

Malignancy in the Cardiac Transplant Patient: Preoperative Selection Criteria and Postoperative Management, Michael Shullo, PharmD

VADs for Support to Pediatric Heart Transplant, Mahesh Sharma, MD

Caring for the Highly Sensitized Pediatric Heart Transplant Patient, Brian Feingold, MD, MS

2:45 p.m.

Break — Exhibits Open

3:00–4:45 p.m.

Lung Transplantation Panel Discussion
Lung transplantation represents the definitive option for patients with end-stage advanced lung diseases. Survival after lung transplantation is suboptimal relative to other solid organ recipients, with multiple factors influencing survival and quality of life. During this panel discussion, learn about lung transplant allograft complications, community-acquired respiratory viral (CARV) infections and its impact on the quality and quantity of life after transplant, and treatment strategies utilized to improve overall survival for lung transplant recipients. This panel will also address challenges and considerations in pediatric lung transplantation.

Learning Objectives:

1. Discuss novel approaches in the management of lung transplant donors and recipients, including the use of ex vivo lung perfusion and how it may impact the future of this field.
2. Explain the difference between acute and chronic rejection in lung transplantation.
3. List risk factors for the development of chronic lung transplant rejection.
4. Identify pathogenic community-acquired respiratory viruses (CARV) and the associated risks and treatment options following lung transplantation.
5. Recognize that children requiring lung transplantation may suffer from pulmonary and systemic diseases that are not commonly seen in adult lung recipients.
6. State the challenges of matching donors and recipients in the pediatric population, particularly given the underlying diseases and their effect on growth and nutritional status.

New Frontiers in Lung Transplantation, Jonathan D’Cunha, MD, PhD

Chronic Lung Allograft Failure, Matthew Morrell, MD

CARV Infections after Lung Transplantation: More than Just the Common Cold, Christopher Ensor, PharmD, BCPS

Challenges and Considerations in Pediatric Lung Transplantation, Geoffrey Kurland, MD

Panel Q & A: Lung Transplantation

4:45 p.m.

Closing Remarks/Adjourn