7:00 a.m.

Registration and Continental Breakfast

8:00 a.m.

Welcome and Opening Remarks, Lisa Jansen, Ambulatory Clinics Director, Director, Digestive Diseases & Kidney Clinical Program, Nebraska Medicine; and Heidi Leenay, Vice President, OptumHealth Education

8:15 a.m.

Innovations in Transplantation, Alan N. Langnas, DO, FACS
Dr. Langnas will give an overview of the history and future of transplantation and the role of quality outcomes and regulations guiding the way.

Learning objectives:

• Summarize the history of transplant and explain how advancements lead to successful transplants.
• State the importance of quality outcome standards and the impact of regulations.
• Review the changes to the new organ-allocation policy and their presumed benefits.

9:00 a.m

Advanced Heart Failure in 2018: Pills, Pumps and Transplants — Oh My! Adam Burdorf, DO, MS
Dr. Burdorf will discuss various treatment options and financial implications for advanced heart failure.

Learning objectives:

• Differentiate among the variety of treatment options and financial considerations for advanced heart failure.
• State the patient-selection criteria for different treatment options for advanced heart failure.
• Discuss when left-ventricular-assist-devices (LVADs) are used as a “bridge to transplant” versus “destination therapy.”

9:45 a.m.

Break — Exhibits Open

10:15 a.m.

Kidney Exchanges — “A Chain Reaction,” Arika Hoffman, MD
Dr. Hoffman will share the remarkable gifts for many transplant recipients through the generosity of anonymous donation and transplant chains.

Learning objectives:

• Explain a transplant chain and how they work, from examples of recent experiences.
• Emphasize the importance of living donation as the need for donation increases.
• Describe the “Board of Hope” and discuss its role in transplant chains.

11:00 a.m.

Infectious Disease and “Super Bugs” in the Posttransplant Patient, Andre Kalil, MD
Dr. Kalil will discuss common posttransplant infectious diseases, as well as concerns regarding super bugs.

Learning objectives:

• Define super bugs.
• Address concerns for common posttransplant infections and super bugs.
• Discuss immunosuppression drugs and their relationship to posttransplant infection risk and growth of a super bug.

11:45 a.m.

End-Stage-Renal Disease Treatment Options: Quality of Life and Financial Considerations, Eric Langewisch, MD
Dr. Langewisch will provide information regarding treatment options for end-stage-renal disease (ESRD) and the financial considerations of dialysis and transplantation.

Learning objectives:

• Discuss current treatment options for ESRD.
• Compare and contrast the financial analysis of dialysis and transplantation.
• Showcase a cost-effective case study.

12:15 p.m.

Lunch (provided) — Exhibits Open

1:15 p.m.

Intestinal Failure Case Studies, David F. Mercer, MD, PhD, FRCS(C), FACS
Dr. Mercer will share medical and surgical therapies in intestinal rehabilitation and transplantation that have shown positive outcomes and financial benefits. He will also discuss the benefits of a comprehensive intestinal rehabilitation and transplant program.

Learning objectives:

• Discuss both medical and surgical current, cutting-edge techniques for intestinal failure.
• Compare and contrast the financial analysis for different treatment options that are available.
• Showcase a cost-effective case study.

2:00 p.m.

Pregnancy in the Posttransplant Patient, Teresa Berg, MD
Dr. Berg will discuss the risks of pregnancy in the posttransplant patient and multidisciplinary management of the patient during the pregnancy.

Learning objectives:

• Discuss potential complications and risks during a transplant patient’s pregnancy and the role of the multidisciplinary team.
• Address the concerns of immunosuppressive therapy while breastfeeding.
• Explain the importance of a planned pregnancy with consideration of organ graft function and immunosuppressive therapy.

2:30 p.m.

The Ins and Outs of Starting a Lung Transplant Program, Aleem Siddique, MD
Dr. Siddique will discuss the organizational commitment, infrastructure, process and regulatory components required to start a new transplant program.

Learning objectives:

• State the importance of foundational and organizational support needed to start a lung transplant program.
• Summarize the regulatory process.
• Discuss the financial challenges faced while waiting to be approved by Centers for Medicare & Medicaid Services.

3:00 p.m.

Break — Exhibits Open

3:15 p.m.

The Ethics of Organ Transplantation, Jacob Dahlke, MSB
Ethical and regulatory requirements often overlap in the field of transplantation. Mr. Dahlke will present examples of case studies that create ethical considerations that transplant centers are faced with in the allocation of human organs, recipient selection and transplantation.

Learning objectives:

• Clarify general ethical principles in health care, including autonomy, beneficence, non-maleficence, justice and fiduciary responsibility.
• Describe ethical principles in the context of organ transplantation, including resource allocation, and individual-level vs. population-level considerations and analyses.
• Highlight barriers in developing a just and efficient transplant program, including offering recommendations for possible solutions.
• Identify the three principles of primary importance in the allocation of human organs: utility, justice and respect for persons for an “equitable” allocation system.

4:15 p.m.

The Teen Years: Transition of Adolescent Transplant Patients to Adulthood, James Sorrell, MD
Transitioning from adolescence to adulthood is a difficult time for all teens. Dr. Sorrell will share insights and strategies to consider with the transition of adolescent transplant patients to adulthood.

Learning objectives:

• Identify the impact of peer relationships and its effect on self-esteem.
• Explain the shift of responsibility from parents to individual self-management.
• Discuss how health care coverage, when transitioning off parents’ insurance, is cause for concern among transplant patients.

4:45 p.m.

Adjourn

7:00 a.m.

Registration and Continental Breakfast — Exhibits Open

8:00 a.m.

Opening Remarks

8:15 a.m.

Oncoplastic Breast Surgery: Barriers, Outcomes and Education, Jessica Maxwell, MD
Oncoplastic surgery is an important consideration in all breast cancer surgeries. The primary goal of surgery in the treatment of breast cancer is always disease eradication, but oncoplastic surgery can help minimize the physical effects and improve the aesthetics of the surgery.

Dr. Maxwell will discuss the range of techniques now possible in oncoplastic breast surgery, from simple and functional to complex and cosmetic. She will discuss when oncoplastic surgery is indicated, and the benefits that can be realized when providing this very individualized care to breast cancer patients.

Learning objectives:

• Describe the principles of an oncoplastic approach to breast-conserving surgery.
• Differentiate between standard lumpectomy and oncoplastic lumpectomy.
• Recognize the importance of oncoplastic surgery in breast cancer care and survivorship.

9:00 a.m.

CAR T-cell Therapy in Hematologic Malignancies: Does Triumph Trump Toxicity? Matthew Lunning, DO
Chimeric antigen receptor (CAR) T-cell therapy has become a very promising therapy in the treatment of select hematologic malignancies. However, CAR T-cells are associated with unique, acute, even fatal toxicities that require detailed monitoring and specialized management.
Dr. Lunning will discuss some of the potential toxicities seen in patients receiving CAR T-cell therapy. He will review recommendations for monitoring, grading, and managing these acute toxicities, including the use of interleukin-6 antagonist when indicated.

Learning objectives:

• List three toxicities associated with CAR T-cell therapy.
• Identify three recommended baseline tests/assessments to be done prior to CAR T-cell infusion.
• Outline key assessments that should be part of routine patient monitoring after CAR T-cell infusion.
• Describe the management of cytokine release syndrome (CRS) and other organ toxicities during CAR T-cell therapy.

10:00 a.m.

Break — Exhibits Open

10:30 a.m.

Pancreatic Cancer: Advances in Detection and Treatment, Kelsey Klute, MD; Chi Lin, MD; and Quan P. Ly, MD
Pancreatic cancer is the third leading cause of cancer death in the U.S. with a median survival measured in months. This panel, consisting of members of the Gastrointestinal Multidisciplinary Clinic, will discuss the advances, challenges, and barriers to screening, early detection, and effective treatment of pancreatic cancer.

Learning objectives:

• List three risk factors that would indicate pancreatic cancer screening is appropriate.
• Describe advances in chemotherapy, targeted therapy, surgical intervention and radiation therapy treatment for pancreatic cancer.
• Recognize the impact of an experienced multidisciplinary team approach in creating a comprehensive treatment strategy for pancreatic cancer.

12:00 p.m.

Lunch (provided) — Exhibits Open

1:00 p.m.

Ethical Considerations: Medical Marijuana, Physician-Assisted Suicide and Cancer Pain Control During an Opioid Epidemic, R. Greg Bociek, MD
Physicians encounter ethical challenges in day-to-day practice. Established ethical principles, legal ramifications, and patient factors all contribute to the decision-making processes surrounding treatment, continuation of treatment, and end-of-life care. These topics are increasingly being covered through media exposure, chat rooms, blogs and an increasing pool of “Internet experts.” Dr. Bociek will discuss some of the current social issues that are creating or influencing ethical decision making and the care being provided to patients with cancer.

Learning objectives:

• Distinguish between legal and ethical issues when considering advocating the use of medical marijuana for cancer-related symptom control.
• Examine issues related to a cancer patient’s request for a physician’s aid in dying.
• Describe strategies to ensure opioids are prescribed and used safely for cancer-related pain control despite concerns with issues of addiction, abuse, and misuse.

2:00 p.m.

Break — Exhibits Open

2:15 p.m.

Allogeneic Hematopoietic Stem Cell Transplant (HSCT) in the Older Adult, Vijaya Bhatt, MD, and Thuy Koll, MD
The incidence of most hematologic malignancies, such as acute myeloid leukemia, increases with age. Allogeneic HSCT provides a life-prolonging or potentially curative treatment option for patients with hematologic malignancies. Due to high transplant-related toxicity, this treatment strategy was initially restricted to younger patients. However, studies are supporting the use of HSCT as a feasible, safe and effective therapy for select older adults.

Drs. Bhatt and Koll will review current studies supporting the role of HSCT in older adults, the evaluation of older transplant candidates and ways to identify those patients at increased risk for transplant-related toxicity. They will discuss how adjustments to the intensity of the conditioning regimen and advances in supportive care can make HSCT a viable treatment option for this population.

Learning objectives:

• Identify indications for HSCT in older adults.
• Discuss transplant-related toxicities in older adults.
• Highlight the value of timely referral of older adults with hematologic malignancies to a transplant center.
• Analyze the reason for a low rate of utilization of HSCT in older adults.
• Recognize the improvement in outcomes of older transplant recipients in more recent years.
• Describe the relevance of identifying comorbidities prior to HSCT in older adults.
• Understand the significance of multidisciplinary management of older transplant recipients.

3:15p.m.

The Good, The Sad, The Ugly, The Beautiful: Having Meaningful End-of-Life Discussions, Melissa Teply, MD
Effective, meaningful end-of-life discussions create a shared understanding of the patient’s values and preferences that can lead to a plan of care respectful of those values and preferences. However, treatment of both the physical and psychosocial aspects of cancer can pose enormous challenges to the communication skills of health care professionals.

This session will review the importance of effective communication in the treatment of cancer, therapy-related symptom management and in patients’ treatment decisions. Barriers to communication and strategies to improve crucial conversations will also be discussed.

Learning objectives:

• Describe the benefit of effective communication and improved symptom control in palliative care.
• List the key components of discussing end-of-life care with patients and families.
• Identify barriers and challenges to successful end-of-life conversations.
• Adopt strategies for improving end-of life-conversations.

4:15 p.m.

Adjourn