8:15 a.m.

Thoracic Transplantation 101: Evaluation, Hospitalization, Posttransplant Care and Complications, Michael Petty, PhD, RN, CCNS, ACNS-BC, University of Minnesota Health

Heart and lung transplantation have revolutionized therapy for end-stage thoracic disease in the last decade. There are important factors that need to be taken into consideration to optimize outcomes for this patient population. The appropriate timing for referral to a transplant program is based on the patient’s functional status and life expectancy. With thoracic transplantation, there is a significant risk of perioperative morbidity and mortality; therefore, each patient needs to be evaluated individually, with consideration for absolute and relative contraindications. This session will discuss the advantages of a comprehensive multidisciplinary approach to managing thoracic transplant recipients. An overview of the criteria and evaluation process for thoracic transplantation, hospital course, and pre- and posttransplant management strategies will be presented along with how a team can work together to achieve optimal patient outcomes.

Learning Objectives:

1. List the physical and psychosocial criteria in current guidelines for eligibility to receive a heart or lung transplant.
2. Describe the process of patient evaluation and selection as well as posttransplant complications and long-term management for recipients of a heart or lung transplant.
3. Discuss the importance to patient outcomes of a multidisciplinary team approach to care delivery.

9:00 a.m.

Left Ventricular Assist Devices (LVADs): Optimal Management to Reduce Morbidity and Mortality in Heart Failure Patients, Michael Petty, PhD, RN, CCNS, ACNS-BC, University of Minnesota Health

An LVAD is a mechanical pump that is used to support heart function and blood flow in people who have weakened hearts. This treatment option is for certain patients with end-stage heart failure and can be used either as a bridge to transplant until a donor heart becomes available for transplant or as destination therapy as an alternative to heart transplant. This session will review (1) candidate selection; (2) management strategies to reduce morbidity and mortality in heart failure patients supported with LVADs; (3) outpatient strategies to optimize device performance and heart failure management; and (4) important device complications that warrant close outpatient monitoring.

Learning Objectives:

1. Discuss candidate selection and outpatient strategies to optimize device performance and heart failure management.
2. Identify management strategies to reduce morbidity and mortality in heart failure patients supported with LVADs.
3. Summarize important device complications that warrant close outpatient monitoring.

10:00 a.m.

Abdominal Transplantation 101: Treatable Diseases, Evaluation, Hospitalization and Posttransplant Care, George E. Loss, Jr., MD, PhD, FACS, Ochsner Medical Center

Organ transplantation has overcome major technical limitations to become the success it is today. The breakthroughs include developing techniques for vascular anastomoses and managing the immune response.The outcomes of organ transplantation continue to improve with advancements in the evaluation and selection process, as well as the peri- and postoperative management of these patients. This session will include an overview of abdominal organ transplantation, organ-specific outcomes, the use of deceased versus living donors, the role of immunosuppression therapy, and short- and long-term complications associated with these surgeries — such as infection, disease recurrence, and acute and chronic rejection.

Learning Objectives:

1. Summarize the pretransplant evaluation process, hospital course and posttransplant care for abdominal transplant patients.
2. Identify organ-specific criteria and the use of deceased- versus living-donor organs.
3. Discuss the role of immunosuppression therapy in abdominal transplantation.
4. List short- and long-term complications that can occur in abdominal organ transplantation, including infection, disease recurrence and rejection.

11:00 a.m.

An Overview of Pharmaceuticals Utilized in Organ Transplantation, Andrew Freeman, PharmD, BCPS, Ochsner Medical Center

The success of solid organ transplantation rests heavily on the major advances in immunosuppressive therapy. With the introduction of improved immunosuppressive agents to prevent graft rejection, as well as antimicrobials and antifungal agents to decrease the risk of opportunistic infection, successful organ transplantation has become the standard. The use of risk education and management strategies (REMS) are becoming increasingly common in organ transplantation, and studies suggest that health care providers must be aware of these strategies to improve patient education and reduce pharmaceutical risk. This session will discuss immunosuppressive agents used in organ transplantation and the major adverse effects for each agent.

Learning Objectives:

1. Discuss induction therapies and current drug protocols used for solid organ transplantation.
2. Explain the mechanism of action of immunosuppressive agents, along with the major adverse effects for each agent.
3. State the risks and benefits of immunosuppressive agents, as well as how to prevent opportunistic infections and/or treat patients with such infections.
4. Identify the role of health care providers in implementing REMS for organ transplantation.

12:00 P.m.

Organ Procurement: Strategies to Close the Gap Between the Supply and Demand for Organs, Stuart C. Sweet, MD, PhD, St. Louis Children's Hospital

Organ transplantation has been limited by the shortage of donor organs, resulting in a significant imbalance between organ availability and the need for organ transplantation services. Despite advances in medicine and technology, as well as increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen. The U.S. Organ Procurement and Transplantation Network (OPTN) helps ensure the success and efficiency of the U.S. organ transplantation system. This session will review the goals of the OPTN and discuss strategies to increase organ donation that will close the gap between suppy and demand.

Learning Objectives:

1. Describe the gap between available donor organs and patients needing transplant, including the impact of this gap on transplant candidates.
2. Describe the role UNOS (as the OPTN contractor) plays as a member of the broader community of stakeholders developing initiatives to bridge this gap.
3. Describe potential strategies to increase the number of patients transplanted, including 1) increasing the number of deceased organ donors; 2) reducing the number of discarded organs; 3) increasing donation from alternative sources; and 4) modifying allocation policies to reduce waiting list mortality.

1:15 p.m.

Immune Tolerance in Kidney and Liver Transplantation: What’s New? R. Mark Ghobrial, MD, PhD, FACS, FRCS (Ed), Methodist J.C. Walter Jr. Transplant Center

One of the biggest battles associated with organ transplantation is the management of side effects resulting from lifelong use of immunosuppression. The toxicity of chronic immunosuppressive agents has prompted investigators to pursue approaches to induce immune tolerance. The goal is to wean transplant recipients off immunosuppressive agents while keeping graft function stable, in the hope of making it possible for patients to live without the need for immunosuppressive drugs. This session will offer information about novel agents that produce immune tolerance, including chimerism and donor-specific tolerance in kidney and liver transplant recipients.

Learning Objectives:

1. State the most recent developments and clinical trials associated with producing immune tolerance in transplant patients.
2. Describe the indications, potential applications, risks and benefits of agents used to produce immune tolerance.
3. Discuss the differential degree of rejection risk among patients undergoing renal versus liver transplantation, and how that difference may impact the development of medications to prevent graft rejection.
4. Explain how some transplanted patients can be weaned off immunosuppressive therapy without sustaining graft loss.

2:00 p.m.

Congenital Heart Disease (CHD): Incidence, Diagnosis, Complications and Management, Wayne J. Franklin, MD, FACC, Texas Children's Hospital, Baylor St. Luke's Medical Center

According to the Centers for Disease Control (CDC), 1 percent of babies born in the United States have congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms. The diagnosis and treatment of CHD has greatly improved over the past few decades and, as a result, almost all children who have complex heart defects survive to adulthood and can live active, productive lives. With this increased longevity, children with CHD grow out of needing pediatric care, and health care providers who take care of adults are now managing this patient population. Studies suggest that this transition may be challenging, and health care providers do not always know the best way to smoothly transition care for these patients This session will review the types, signs and symptoms, diagnoses, and treatments for complex CHD. It will also review the impact congenital heart defects have on quality of life and self-efficacy in children and adults with this disease and the challenges that children face as they transition from pediatric to adult care.

Learning Objectives:

1. Discuss the incidence, diagnoses, types, treatment and complications of CHD and its impact on quality of life.
2. Outline the differences between pediatric and adult medical and psychosocial needs for treating CHD, as well as the importance of referral to a specialized center to optimize outcomes.
3. Recognize the importance of working as part of an interdisciplinary team to identify barriers and strategies to improve support for patients with CHD and their families.

2:45 p.m.

Chronic Kidney Disease (CKD): Overcoming Barriers to Patient Care and to Successful Implementation of Clinical Guidelines, Cybele Ghossein, MD, Northwestern Medicine

The CDC reports that over 20 million adults in the United States suffer from CKD. Despite the presence of clinical guidelines, including those created by the National Kidney Foundation, studies suggest that there are numerous barriers to implementation, such as patient-, provider- and system-associated barriers. This session will review the latest treatment guidelines for CKD, outline a model to identify at-risk patients and discuss how to effectively overcome barriers to care. It will also review the importance of optimal timing for referral of CKD patients to a nephrologist.

Learning Objectives:

1. State the prevalence, diagnosis, and management of CKD and how to identify at-risk patients.
2. Identify optimal timing for referral of CKD patients to a nephrologist and methodologies for early identification of patients with CKD.
3. Discuss the latest treatment guidelines for CKD and be able to identify barriers to implementing these guidelines.
4. Identify strategies to communicate more effectively with CKD patients and overcome barriers to their care.

3:30 p.m.

Adjourn