7:00 a.m.

Registration and Continental Breakfast — 4th Floor Atrium

8:00 a.m.

Welcome and Opening Remarks — Grand Portage Ballroom, 4th Floor

8:30 a.m.

25 Years: The Biggest Changes in Health Care and What the Future May Hold, Alan Langnas, DO, Nebraska Medicine

Throughout the past quarter century, we have witnessed radical treatment advances such as the major developments in immunosuppression for organ transplantation; the public health and clinical benefits of statins; the impact of genomics on the entire field of medicine; the introduction of targeted biopharmaceuticals; the advent of oral antiviral agents for hepatitis C that are capable of cure; and the use of vaccines as cancer prevention. Additionally, the decrease of tobacco use has had a significant effect on prevention.

With cultural shifts, policy adjustments, the price of care and technological advances, the hospital industry has moved toward a more patient-empowered approach that prioritizes prevention, as it continues to evolve by streamlining and improving patient care.

Dr. Langnas will highlight the past 25 years of momentous advances and stunning innovations in health care that have ensued from the use of advanced technologies and life-saving approaches. He will also take a look down the road at what changes we may see in health care during the next decade and beyond.

Learning Objectives:

1. List the major advances and innovations in health care over the past 25 years.
2. State how the impact of technological innovations has fundamentally changed patient care.
3. Identify advances in health care that have influenced a more patient-empowered approach.
4. Explain how health care continues to evolve with the use of multidisciplinary teams and how this approach optimizes patient outcomes and quality of life.
5. List potential changes that may occur in health care with increased technological advances.

9:15 a.m.

A Cure for Diabetes? Innovations from Pancreas to Islet-Cell to Beta-Cell Transplantation, Dixon B. Kaufman, MD, PhD, FACS, University of Wisconsin School of Medicine and Public Health, University Hospital

The discovery of insulin transformed type 1 diabetes from a fatal disease to a manageable condition, but it remains a very serious chronic illness. Islet-cell or pancreatic transplantation can, in principle, cure type 1 diabetes, but lifelong immunosuppressive therapy is required and the lack of donor pancreas tissue has led to attempts to find alternative treatment of type 1 diabetes. This session will discuss the Clinical Islet Transplantation Consortium (CIT) study and the advances in pancreatic-islet-cell transplant and kidney/pancreas transplant. It will also explore the utility of stem-cell-derived beta cells for future treatment of diabetes and the challenges faced in developing beta-cell replacement therapies.

Learning Objectives:

1. Provide a brief overview of the history of pancreas transplantation for the treatment of type 1 diabetes.
2. Identify advances in the technical and immunologic aspects of islet transplantation that resulted in achieving long-lasting insulin independence.
3. Analyze the results of the Clinical Islet Transplantation Consortium (CIT) study through the National Institutes of Health (NIH) for allogeneic islet-cell transplantation for the treatment of diabetes.
4. Discuss the utility of stem-cell-derived beta cells for future treatment of diabetes and the challenges faced in developing beta-cell-replacement therapies.
5. Describe factors health care providers should consider when referring patients for pancreatic islet cell transplant and kidney/pancreas transplants.

10:00 a.m.

Break — 4th Floor Atrium

10:15 a.m.

Developments and Advances in Medical Management of Diabetes, Anne Peters, MD, Keck School of Medicine of USC

Morbidity from diabetes involves both macrovascular (atherosclerosis) and microvascular (retinopathy, nephropathy, and neuropathy) diseases. Interventions can limit organ damage and, therefore, patients with diabetes require initial and ongoing evaluation for diabetes-related complications. Weight management and the prevention of cardiovascular morbidity is a major priority for patients with diabetes, especially type 2 diabetes mellitus (T2DM). This session will analyze why glycemic control is important in the long term to reduce the onset and severity of the complications of type 2 diabetes, as well as to reduce macrovascular risk. It will also discuss the significant metabolic benefit of medications that are used to aid in weight loss in the management of diabetes and review medical management approaches consistent with guidelines from the American Diabetes Association (ADA) for health maintenance in patients with diabetes.

Learning Objectives:

1. Review the mechanism of action and therapeutic utility of DPP-4 inhibitors and SGLT1 receptor agonists for the treatment of T2DM.
2. Explain how SGLT2 inhibitors could dramatically improve glycemic control in type 2 diabetes and how this new class of drugs may boost overall health by promoting weight loss.
3. Recognize why glycemic control is important in the long term to reduce the onset and severity of the complications of T2DM, as well as to reduce macrovascular risk.
4. List drugs that are used to aid weight loss in the management of diabetes, and state the significant metabolic benefits of these medications.
5. Discuss the increasing focus on a personalized approach in determining the degree of blood sugar control in this patient population.

11:15 a.m.

Exhibit Hall Grand Opening and Lunch — Exhibit Hall, 4th Floor

12:45 p.m.

Current Issues in HIV: Successes, Challenges and Epidemic Trends, Timothy Schacker, MD, University of Minnesota

The first benchmark along the continuum of human immunodeficiency virus (HIV) care is diagnosis. At the time of HIV diagnosis, patients should be evaluated to assess the stage of the disease and establish a baseline to help determine management plans and goals. Timely linkage to care following diagnosis is the next step, and the more quickly newly diagnosed individuals enter HIV care, the better their health outcomes. Antiretroviral therapy (ART) may be initiated more promptly, with a subsequent reduction in viral load, which leads to improved health outcomes and a reduction in HIV transmission. To achieve optimal clinical outcomes and to realize the potential public health benefit of treatment as prevention, attention to each step in the treatment cascade is critical. Given the many available assessment strategies and interventions, the challenge for the treatment team is to select the techniques that best fit each patient and patient population. This session will discuss how interdisciplinary teams of health care providers can address the timeliness of treatment and encourage adherence to ART, including programs in place through local and state health departments.

Learning Objectives:

1. Explore the concern that, although treatment approaches continue to evolve, HIV continues to represent a significant public health issue.
2. Describe barriers to care among different patient populations, including marginalized patients and older adults.
3. State ways in which interdisciplinary teams of health care providers can improve the timeliness of treatment and encourage adherence to ART, including programs in place through local and state health departments.
4. Identify important research being performed by scientists at the Centers for Disease Control (CDC), focusing on the continuum of care for individuals diagnosed with HIV.

1:30 p.m.

Relationship Between Physical and Mental Health in Children and Adolescents, Barry Sarvet, MD, The University of Massachusetts Medical School at Baystate

Medical science increasingly recognizes the vital link between physical and mental health. Consequences of adverse experiences are major risk factors for the leading causes of psychological and physical illness in children and adolescents. Adolescent psychological problems are often accompanied by physical symptoms. A prevalent mental disorder experienced among adolescents is depression, and a disturbing potential consequence of adolescent mental health disorders is the incidence of suicide. Prevention requires a comprehensive approach that influences all levels of the social ecology, including community involvement, relationships among families and neighbors, and individual behaviors. This session will identify the relationship between physical and mental health and its impact on children and adolescents.

Learning Objectives:

1. State the relationship between physical and mental health and its impact on children and adolescents.
2. Discuss how adverse experiences in childhood can lead to causes of psychological and physical illness in children and adolescents.
3. Explore the influence of depression on outcomes and costs of chronic diseases in the pediatric and adolescent populations.
4. Describe the impact of mental health disorders on the incidence of suicide in adolescents.

2:15 p.m.

Break — Exhibit Hall, 4th Floor

3:00 p.m.

Reducing the Burden of Heart Failure: Patient-Centered Care and Process Improvement, Michael Petty, PhD, RN, CCNS, ACNS-BC, University of Minnesota Health

According to the CDC, 5.1 million Americans are currently diagnosed with congestive heart failure (CHF) at a cost of $32 billion dollars per year. Half of these patients will die within five years of diagnosis. Despite the seriousness of this condition, health care providers struggle with how to diagnose, treat, and manage complications in patients with heart failure. During this session, Dr. Petty will review the importance of interdisciplinary teams of health care providers to effectively communicate with marginalized populations — including older adults, patients with advanced heart failure, and long-term care residents — about their prognosis, emergency situations, and advanced-care planning as forms of patient-centered care for heart failure. Treatment options for optimal management of heart failure will also be reviewed.

Learning Objectives:

1. Discuss the pharmacologic and nonpharmacologic treatments for managing heart failure.
2. As members of an interdisciplinary team, review effective communication strategies for establishing rapport and creating treatment plans with vulnerable patient populations.

4:00–5:00 p.m.

Hematopoietic Cell Transplant (HCT): Moving Beyond Survival — The Patient’s Perspective, Linda Burns, MD, National Marrow Donor Program (NMDP)/Be The Match; Jan Perske, Bone Marrow Transplant Recipient Mom and Caregiver; Greta Perske Hokanson, Bone Marrow Transplant Recipient; Ed Plass, Double Cord Blood Transplant Recipient; and Kate Plass, Transplant Recipient Spouse and Caregiver

HCT is a complex and costly treatment that is often the only potentially curative therapy available for patients with hematologic malignancies and genetic/immune disorders. Transplant recipients and their caregivers often experience new physical, emotional, social and financial challenges posttransplant. NMDP/Be The Match is partnering with the transplant community to better understand what matters most to recipients and caregivers and to develop a patient-reported-outcomes HCT research agenda. This unique panel session of transplant recipients and their caregivers will provide you with a very personal view into the triumphs and challenges of receiving this life-saving treatment.

Learning Objectives:

1. Identify transplant recipient- and caregiver-reported challenges with regard to HCT treatment and coordination of care.
2. Describe the systemic barriers related to these identified challenges.
3. State the importance of measuring value and outcomes in addition to survival rates.
4. Discuss the aims of the Patient-Centered Outcomes Research Institute- (PCORI-) funded project, Engaging Patients in Developing a Patient-Centered Hematopoietic Cell Transplant Research, led by NMDP/Be The Match.

5:00–6:30 p.m.
New date & time

Optum Provider Network Reception — 6th Floor, Minnesota Room
(Ticketed event; by invitation only.)

7:15–8:15 a.m.

9th Annual Wellness Walk — Check in at 4th Floor Registration Desk 
>Learn more about the Wellness Walk
Support for this activity is provided by Novo Nordisk.

8:00 a.m.

Registration and Continental Breakfast — Exhibits Open (optional) — 4th Floor

9:00 a.m.

Welcome and Opening Remarks — Grand Portage Ballroom, 4th Floor

Frontiers in Medicine

9:15 a.m.

Manipulating the Microbiome: Potential Future Applications, David F. Mercer, MD, PhD, FRCS(S), Nebraska Medicine

The human microbiota has attracted attention as one of the most intriguing and underexplored areas of medical research. While there have been several promising avenues for future development of the microbiome, microbial replacement therapies will likely become standard practice as we further understand the possibilities, limitations, and implications of the microbiome. This session will discuss human microbiome and the role of microbiota and its new clinical applications.

Learning Objectives:

1. Describe the influence of the gut microbiome on human physiology and health and its potential future applications.
2. Provide a state-of-the-art review of fecal microbial transplantation (FMT) as to its present FDA-approved indications and potential future applications.

9:45 a.m.

Hand Transplantation: Developing an Innovative Therapy, Linda C. Cendales, MD, Duke University Medical Center

The first successful hand transplantation took place in 1998 and since this time there have been close to 100 such operations performed. In 1999, Dr. Cendales, the only hand transplant surgeon in the U.S. trained in both hand and microsurgery and hand transplantation, helped organize the team that performed the first U.S. hand transplant. During this presentation, Dr. Cendales will provide an overview of the history of hand transplantation, which, like other forms of organ transplantation, is a major surgical procedure requiring lifelong immunosuppression to prevent rejection of the transplanted hand.

Learning Objectives:

1. Identify the steps followed to establish a hand transplant program.
2. Provide an overview of this highly complex procedure and the interprofessional team that are involved in the process.
3. Evaluate the future of hand transplantation as a therapeutic option after loss of one or both hands.
4. Discuss patient selection and current state of hand transplantation.

10:15 a.m.

Break — Exhibit Hall, 4th Floor

10:45 a.m.

Understanding Myeloma Genetics May Lead to Individualized Therapies, Brian Van Ness, PhD, University of Minnesota Cancer Center; Jenny Ahlstrom, Myeloma Crowd and CrowdCare Foundation

The treatment of multiple myeloma (MM) is complex because of rapid advances in stem-cell transplantation, medications, and better supportive care, all of which have led to improved patient survival. Overall, the care of patients should focus on treatment of the disease process and any associated complications. The diagnostic criteria for and management of MM in the updated 2016 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) broadens the population of patients eligible for therapy by expanding the active myeloma category and also integrating novel therapies at all stages of the disease. Dr. Van Ness will review current and new therapeutic approaches for the treatment of MM and will address the challenges that exist in the treatment of this disease. He will also identify genetic approaches to characterize variations in tumor progression and will address how to determine the best therapy to maximize effectiveness and response for each individual patient.

Learning Objectives:

1. Describe current therapeutic approaches in the treatment of multiple myeloma (MM).
2. List some of the challenges that exist in the treatment of MM.
3. Identify genetic approaches to characterize variations in tumor progression and response.
4. Discuss ways of determining which therapies work best for each individual.
5. Describe the role of using genetics and bioinformatic tools to identify individual tumor signatures of response or resistance.

The Myeloma Crowd and CrowdCare Foundation were created by Jenny Ahlstrom after she was diagnosed with myeloma. On realizing that less than 5 percent of patients joined clinical trials, she started Myeloma Crowd Radio and began interviewing myeloma experts who share the latest research and open clinical trials in patient-friendly language in order to encourage participation in clinical trials. She has now held over 80 interviews with over a million listeners/readers. During this session, Ms. Ahlstrom will discuss how Myeloma Crowd believes that educated and involved patients can drive better outcomes for themselves, be part of the solution to better care, and accelerate the discovery of a cure for their own disease. 

Learning Objectives:

1. Understand the treatment and management of an MM diagnosis from a patient’s perspective.
2. State the vital role education plays in empowering patients to participate in their treatment pathway and optimize their care.
3. Explain the potential impact of participating in a clinical trial to enable patients with MM to receive the most current treatments while assisting in research for a cure.
4. Recognize the importance of receiving treatment from a myeloma specialist versus a general oncologist.

11:30 a.m.

Hepatitis C Virus (HCV): Treatment Guidelines to Screen and Diagnose for Optimal Management, Paul Kwo, MD, Stanford University

Chronic infection with the HCV primarily harms the liver, with liver cancer being a well-known consequence in some individuals — especially those who already have cirrhosis. Recent advances in the number and types of medications available to treat hepatitis C provide more options to consider when deciding on a treatment plan. Until a few years ago, there were only a few drugs approved by the FDA to treat hepatitis C, but newly available drugs have revolutionized treatment. These advances have made treatment regimens shorter in duration, less difficult to tolerate and more effective. This session will discuss the most recent evidence-based treatment guidelines to screen, diagnose and manage patients with HCV. Potential barriers to care will also be identified, as well as the latest pharmaceutical interventions for the treatment of HCV.

Learning Objectives:

1. Discuss the most recent evidence-based treatment guidelines to screen, diagnose and manage patients with HCV.
2. Describe the indications, rates of viral eradication and adverse reactions of the latest pharmaceutical interventions for the treatment of HCV.
3. Identify potential patient barriers to care through the use of direct-acting antivirals, including cost, fear of side effects and concern about treatment duration.

12:15 p.m.

New! Special Guest Keynote Luncheon Presentation, Richard Migliori, MD, Executive Vice President of Medical Affairs and Chief Medical Officer, UnitedHealth Group— Grand Portage Ballroom (This session is not accredited; lunch is provided.)

1:30 p.m.

Dessert Reception — Exhibit Hall, 4th Floor

2:30 p.m.

Evolving Concepts in Cancer Immunotherapy: Prospects for a Cure, Matthew A. Lunning, DO, University of Nebraska Medical Center

In the last few decades, immunotherapy has become an important part of treating some types of cancer. Different types of immunotherapy include monoclonal antibodies, cancer vaccines, chimeric-antigen receptor (CAR) T-cell therapy and immune-checkpoint inhibitors. This session will describe the various types of immunotherapy and outline their clinical applications. The underlying principles of tumor immunology and immunotherapy will be discussed, as well as the appropriate selection of patients and the therapeutic effectiveness of immunotherapy to ultimately improve patient outcomes.

Learning Objectives:

1. Define immunotherapy and distinguish it from chemotherapy.
2. State key principles of tumor immunology and immunotherapy.
3. Analyze recent research and clinical applications of cytokines, cancer vaccines, T-cell-checkpoint inhibitors, adoptive immunotherapy, and biomarkers.
4. Recognize the importance of interdisciplinary management and improve communication with patients and colleagues about adherence to immunotherapeutic protocols and end points for therapy after achieving remission.

3:15 p.m.

Incompatible Kidney Transplantation: National Strategies and Outcomes, Dorry Segev, MD, PhD, Johns Hopkins University

The considerable shortage of organ donors and increasing number of patients with end-stage renal disease has led to an extended waiting time for potential renal-allograft recipients. ABO-incompatible kidney transplantation was previously considered to be an absolute contraindication for patients with end-stage kidney disease (ESKD) due to hyperacute rejection related to blood-type barrier. With the need to expand the donor pool and minimize shortage of kidneys for transplantation, ABO-incompatible kidney transplantation (ABOi KT) was introduced. Another way to offset the extended waiting time and shortage of organ donors is Kidney Paired Donation (KPD) as a transplant option for candidates who have a living donor who is medically able, but cannot donate a kidney to their intended candidate because the two individuals are physiologically incompatible.
This session will discuss the various approaches to matching and allocation in KPD and identify strategies for transplantation across blood barriers in ABO-incompatible kidney transplantation.

Learning Objectives:

1. Discuss the various approaches to matching and allocation in KPD.
2. Identify strategies for kidney transplantations across blood barriers.

4:00–5:00 p.m.

Age Over 70: Heart Transplant or Ventricular-Assist Device (VAD)? Joseph G. Rogers, MD, Duke University Medical Center; and Jeffrey Teuteberg, MD, University of Pittsburgh Medical Center

Dramatic advances in VAD design and patient management have made mechanical circulatory support an attractive therapeutic option for the growing pool of elderly heart failure patients. There are three major indications for the use of VADs: 1) as a bridge to transplantation; 2) as a lifelong support alternative for patients deemed ineligible for heart transplantation, or so-called destination therapy; and 3) as a bridge to myocardial recovery. One of the most controversial issues in the field of patient selection for advanced heart failure is age. Many health care professionals are reluctant to list “elderly” candidates for transplant though the cutoff age varies. In contrast, there is no absolute age cutoff for VADs, and older patients may have easier access to mechanical pumps than to donor organs. During this session, two experts will debate the point/counterpoint for VAD-versus-heart transplant for this patient population. The criteria for patient selection for transplant and VADs, long-term survival and quality of life will be compared.

Learning Objectives:

1. Debate the pros and cons of heart transplant versus VAD for patients over 70 years of age.
2. Compare the indications for and differences in long-term survival and quality of life for elderly patients with heart transplant versus mechanical circulatory support.

5:30–9:00 p.m.

25th Anniversary Gala—6th Floor
Let's "Party Like It's 1991" at our 25th anniversary gala. Please join us in celebration with a night of food, cocktails, casino games, music and dancing. This is one party you don’t want to miss.

Support for the Gala is provided by UW Health Transplant Program and City of Hope National Medical Center.

7:30–8:45 a.m.
New event!

Optum Client Breakfast Discussion: Patient and Donor Perspectives on Bone Marrow Transplantation — 6th Floor, Minnesota Room — (Ticketed, nonaccredited event; by invitation only.)
This invitation-only breakfast will include a discussion with Optum Transplant Solutions and Be the Match, featuring patient and donor perspectives on bone marrow transplantation.

8:00 a.m.

Continental Breakfast — 4th Floor Atrium

9:00 a.m.

The Business of Transplant: A Conversation with Experts, Michael Abecassis, MD, MBA, Northwestern University; C. Fred LeMaistre, MD, Sarah Cannon; John P. Roberts, MD, University of California, San Francisco Medical Center; and Elizabeth A. Pomfret, MD, University of Colorado Anschutz Medical Center

This session will feature a panel of experts who will discuss their experience in developing a value-based model for transplantation, as well as how this model is being emulated by other disciplines in health care. The impact of the Affordable Care Act (ACA) on this field of medicine will also be explored.

Learning Objectives:

1. Discuss the value-based care and payment models inherent to transplantation, and discuss how this model is being emulated by other disciplines in health care.
2. Explain the potential impact of ACA on the current transplantation care model.
3. Understand the key patient- and health-system-related barriers to expanding episodes of care (postacute care and transitions of care).
4. Discuss outcomes transparency as an element of the ACA, and define the impact of Centers for Medicare & Medicaid Services (CMS) regulations regarding outcomes on donor and recipient selection.

10:00 a.m.

Break — 4th Floor Atrium

10:15 a.m.

How to Improve Quality and Value in Health Care, Fred LeMaistre, MD, Sarah Cannon

Transplantation leads to better health, increased activity and an improved quality of life for most recipients. Transplant success can be highly dependent upon transplant timing and referral along with coordination of care for optimal outcomes posttransplant. One barrier to transplant is the lack of coverage options for many American seniors, who are unable to afford or access transplant because of out-of-pocket costs and outdated Medicare reimbursement policies. This session will discuss the importance of appropriate, timely delivery of care and explain gaps in care along with the challenges and barriers that impede access to these life-saving procedures.

Learning Objectives:

1. Explore the importance of identifying patients at the right time for transplant and the impact this has on patient outcomes.
2. Discuss the critical importance of coordination of patient care pre- and posttransplant.
3. Identify gaps in care, challenges and barriers to transplantation.
4. Explain Medicare policy as it relates to transplantation.

11:00 a.m.

Controversies in Transplantation: A Panel Discussion, Michael Abecassis, MD, MBA; Elizabeth A. Pomfret, MD; John P. Roberts, MD; and Joseph G. Rogers, MD
Transplantation has been recognized as one of the most gripping medical advances of the century. While this discipline offers the gift of life, it also generates some controversial discussion. During this session, our panelists of transplant experts will address some of the ethical and/or controversial topics surrounding this field.

• Dr. Joseph Rogers: Pros and Cons for the Proposed Change in the Heart Allocation Policy
• Dr. Elizabeth Pomfret: New Distribution Proposals in Liver Transplantation
• Dr. John Roberts: Impact of SRTR Outcomes Monitoring on Innovation and Risk in Liver Transplantation
• Dr. Michael Abecassis: Controversies Surrounding Recent Liver Transplantation Guidelines for HCC

Learning Objectives:

1. Discuss the pros and cons for the proposed change in the heart allocation policy.
2. Identify potential disparities in liver transplantation through redistricting.
3. Discuss the associated controversies surrounding recent guidelines for liver transplantation for hepatocellular carcinoma (HCC), as well as living-donor liver transplantation (LDLT) for this population.
4. State the pros and cons of the Scientific Registry of Transplant Recipients (SRTR) Transplant Program-Specific Reports, including risk-adjustment models to assess transplant program performance.

12:00 p.m.

Adjourn