Ethical Principles in the Allocation of Organs, R. Mark Ghobrial, MD, PhD, FACS, FRCS (Ed), Houston Methodist
Equitable access to the transplant waiting list is the cornerstone of fair organ allocation. The process of placement on the list determines whether ethical principles of allocation are applied in reality. Utility, justice and respect for persons are three foundational ethical principles that create a framework for the equitable allocation of scarce organs for transplantation. This session will provide a brief description of the regulatory framework under which the Organ Procurement and Transplantation Network (OPTN) operates and will discuss factors relevant to access to the transplant waiting list.
- List three ethical principles of primary importance in the allocation of human organs.
- Describe the regulatory framework under which the OPTN operates.
- Discuss factors relevant to access to the transplant waiting list.
Blood/Marrow Transplantation (BMT): When Is the Right Time to Transplant? Dennis L. Confer, MD, National Marrow Donor Program(NMDP)/Be The Match
In general, patients transplanted in earlier disease stages have better outcomes than patients transplanted in more advanced disease stages. Studies on BMT have revealed that transplant success can be highly dependent upon transplant timing. This session will discuss the 2017 referral timing guidelines that were developed jointly by the NMDP/Be The Match and the American Society for Blood and Marrow Transplantation (ASBMT), based on current clinical practice, medical literature, and evidence-based reviews.
- Outline the 2017 referral timing guidelines that were developed jointly by the NMDP/Be The Match and the ASBMT.
- Discuss how disease stage at the time of transplant and appropriate planning and early donor identification can have significant impacts on patient survival.
Direct-acting Antiviral Agents (DAAs) for the Treatment of Hepatitis C Virus (HCV), Michael Abecassis, MD, MBA, Northwestern University
Chronic HCV infection is a global epidemic. DAAs provide new opportunities for treatment of HCV recurrence, which has changed the management of both liver and kidney transplant recipients pre- and posttransplant. Treatment of established HCV infection posttransplantation also yields substantial improvements in patients’ (and their grafts’) survival. The key challenge is to ensure that the right patient is receiving the right treatment at the right time. This session will discuss the recent breakthrough in HCV treatment; the importance of timing this treatment; the benefits and its challenges.
- Discuss how DAAs have changed the management of both liver and kidney transplant recipients pre- and posttransplantation.
- State the importance of receiving the right treatment for the right patient at the right time.
- Describe the criteria for initiation of DAAs for HCV, including medication adherence and ongoing monitoring, and explain how they have changed the management of both liver and kidney transplant recipients pre- and posttransplantation.
- Describe the indications, rates of viral eradication and adverse reactions of the latest pharmaceutical interventions for the treatment of HCV.
11:15 a.m.–12:00 p.m.
Acute Myeloid Leukemia (AML) in the Elderly, Lori S. Muffly, MD, MS, Stanford University Medical Center
Among patients with AML, treatment regimens and outcomes may differ between younger and older adult populations. The management of elderly patients with AML can be a difficult challenge. Elder adults are more likely to have comorbidities that can limit treatment options. Therefore, treatment decisions should be individualized and take into account the age and performance status of the patient. This session will discuss the goals of therapy, the side effects of treatment, and the potential benefits of treatment with regard to both short- and long-term outcomes in the older adult population.
- State key factors when treating AML in an elderly patient.
- Identify appropriate therapeutic strategies for the elder patient with AML.
- Discuss potential benefits of treatment for AML with regard to both the short- and long-term outcomes.
Using Telehealth to Enable Patient-centered Care for Transplant, Jennifer M. Kerney, MSN, CRNP, UCSF Medical Center
Telehealth is an emerging technology that has potential to serve the health care needs of individuals. Organ transplant is a highly complex and resource-intensive intervention and, because of the complexity of their medical conditions, recipients require a high level of specialized care. Patients often incur comorbidities of chronic immunosuppression, which leave recipients at high risk for various complications and subsequent rehospitalization, all of which are associated with worse long-term outcomes and significantly reduced patient and graft survival. This session will discuss how telemonitoring may potentially be used to support patients and caregivers to predict and circumvent treatable causes for readmission and improve their communication with health care professionals, thereby improving health care costs, quality of life, and posttransplant survival. Included during the presentation will be an overview of Project ECHO® (Extension for Community Healthcare Outcomes) — a movement designed to demonopolize knowledge and amplify the capacity to provide best practice care for underserved people all over the world.
- Describe the role of telehealth and its use in the treatment of liver transplant recipients.
- Discuss the benefits and challenges of telehealth including its use for psychosocial evaluations in kidney transplant.
- State how telemonitoring may be used to prevent and circumvent treatable causes for posttransplant readmission.
- List current and future ECHO (Extension for Community Healthcare Outcomes) initiatives.
Kidney Transplantation as Primary Therapy for End-stage Renal Disease, Clifford D. Miles, MD, Nebraska Medicine
Kidney transplantation is the most desired and cost-effective modality of renal replacement therapy for patients with irreversible chronic kidney failure. Despite evidence that the best outcomes are achieved by those who receive a transplant early in the course of renal replacement therapy, only a small percentage of patients with end-stage renal disease undergo transplantation as their initial modality of treatment. This session will discuss the importance of timely transplant evaluations, identification of potential living donors, and early transplantation, as well as describe the advantages and barriers to preemptive transplantation.
- Outline the importance of timely transplant evaluations, identification of potential living donors and early transplantation.
- Discuss advantages of preemptive transplantation.
- Describe the barriers to preemptive transplantation.
The Role of Immunotherapy in Cancer Treatment, Edward A. Stadtmauer, MD, Abramson Cancer Center, Penn Medicine
Immunotherapy is one of the most exciting areas of new discoveries and treatments for many different types of cancer. Understanding how the immune system works is opening the doors to developing new treatments as a promising new strategy to treat 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. In addition, the specific role of immunotherapy in individuals with multiple myeloma will be addressed.
- Explain cytokines, cancer vaccines, chimeric-antigen receptor (CAR) T-cell therapy and checkpoint inhibitors, adoptive immunotherapy, and biomarkers, and analyze their recent research and clinical applications.
- State the role of immunotherapy in multiple myeloma.
Management of Patients Going Through Immunotherapy Cancer Treatment, Patricia Mangan, CRNP, Abramson Cancer Center, Penn Medicine
Cancer treatment often involves multiple options and specialties. Treatments can be toxic, costly, intense, prolonged, and may result in serious long-term complications. In addition, responses to cancer treatments are quite variable, so predicting the potential risks and benefits of various treatment options for individual patients is often difficult. Recognizing the challenges with the complexity of treatments coupled with the life-threatening nature of cancer, this session will discuss the patient experience and the management of patients going through immunotherapy cancer treatment.
- Describe the complex management of patients with cancer including the toxicities of their treatment through their recovery.
- Discuss the experience and challenges that patients face when going through immunotherapy cancer treatment.