Transplantation in 2015: Advances in Solid Organ and Blood/Marrow Transplantation

Dallas, TX US
August 27, 2015

THURSDAY, AUGUST 27, 2015 Up to 7.25 continuing education credits available — ACPE UAN 0860-9999-15-021-L01-P

8:00 a.m.

Therapeutic Options for Advanced Heart Failure, Mark Drazner, MD

This session will review simple clinical markers that identify patients with advanced heart failure that should be referred to advanced heart failure centers, the prognosis of such patients without advanced therapies and the treatment options available to them.

Learning Objectives:

  1. Recognize how to identify patients with advanced heart failure based on simple clinical features.
  2. Explain the natural history of patients with advanced heart failure.
  3. State the risks and benefits of left ventricular assist devices and cardiac transplantation in patients with advanced heart failure.

8:30 a.m.

Neuromuscular Cardiomyopathy: A Novel Mode of Maladaptive Cardiac Remodeling, Pradeep P.A. Mammen, MD, FAHA, FACC

Neuromuscular disorders represent an array of inherited myogenic disorders involving mutations and/or dysregulations of a variety of cytoskeleton or nuclear proteins within the myocyte. Despite the high incidence of end-stage cardiomyopathy amongst patients with neuromuscular disorders, there is limited data regarding the mode of maladaptive cardiac remodeling that develops. During this presentation, we will review the most common types of neuromuscular disorders and the pathophysiology underlying cardiomyopathies in this patient population, as well as outline a treatment approach to potentially improving cardiac function is these patients.

Learning Objectives:

  1. Describe the variety of neuromuscular disorders that can afflict patients.
  2. State the pathophysiology that underpins the development of cardiomyopathies in patients with neuromuscular disorders.
  3. Outline a practical approach to the management of neuromuscular cardiomyopathies.

9:00 a.m.

Heart Transplantation in Adults with Congenital Heart Disease (ACHD), Alpesh Amin, MD

Due to rapid advances in surgical and medical interventions in the pediatric population, ACHD is now more prevalent than ever — there are an estimated 750,000 adults with ACHD in the U.S. This presentation will discuss the treatment options for this patient population, including the challenges faced with heart transplantation and the importance of subspecialty care for these patients.

Learning Objectives:

  1. Describe the growing population of ACHD.
  2. Define the need for advanced therapy options in the ACHD population.
  3. Review the challenges in performing heart transplantation in the ACHD population.
  4. Identify the need for specialized centers for heart transplantation in the ACHD population.

9:30 a.m.

Expanding the Donor Pool for Heart Transplantation, Matthias Peltz, MD

Heart transplantation remains the most effective therapy for end-stage cardiac disease. Fewer than 2,500 patients are transplanted annually, while nearly 4,000 candidates are on the heart transplant waiting list. Conventional wisdom suggests that most suitable donor hearts are procured for transplantation, however, currently only approximately 30 percent of eligible cardiac donors are actually transplanted, indicating that a number of potentially suitable organs are being discarded. This session will examine donor variables that affect outcomes after transplantation and discuss strategies that can be used to increase the donor pool for cardiac transplantation.

Learning Objectives:

  1. Identify donor variables that impact outcomes after heart transplantation.
  2. Discuss use of older and other extended donors for cardiac transplantation.
Lung Transplantation
Over the past 25 years, lung transplantation has become a viable treatment option for patients with a variety of end-stage lung diseases. Lung transplantation techniques have continued to evolve in the past decade with the advent of newer technologies supporting ExtraCorporeal Membrane Oxygenation (ECMO). These technologies have allowed an expanded role of ECMO to support lung transplant waitlist patients who deteriorate while awaiting transplantation. The role of ECMO for intraoperative recipient support during transplantation is also being explored and defined. In addition, since the first successful lung transplantation in 1963, tremendous progress has been made in the development of immunosuppression regimens to prevent acute and chronic rejection of the lung allograft and to reduce the risk of opportunistic infection (a major side effect of immunosuppression).These next sessions will focus on the advances within the field of lung transplantation, including the factors that influence positive outcomes for this population.

10:15 a.m.

Medical Considerations for Lung Transplantation, Fernando Torres, MD

Learning Objectives:

  1. Explain the implications of immunology in patients after lung transplantation.

10:45 a.m.

Advances in Ex Vivo Lung Perfusion (EVLP): A Multidisciplinary Approach, Pietro Bajona, MD and Jenna Bland, RN

Learning Objectives:

  1. Review the technical details of EVLP.
  2. Explain the rationale behind EVLP.
  3. State the worldwide clinical experience with the EVLP, including the Toronto technique and others.
  4. Discuss the growing literature on EVLP application for donation after cardiac death (DCD) lungs.

11:15 a.m.

Surgical Advances in Lung Transplantation and ECMO, Michael Wait, MD

Learning Objectives:

  1. Outline the role ECMO plays in a lung transplant program.
  2. Explain the emerging role XVIVO plays in a lung transplant program.
  3. State donor and recipient factors that affect lung transplant outcomes.

1:00 p.m.

Lung Transplant Outcomes and More… Fernando Torres, MD

Learning Objectives:

  1. List factors that impact quality outcomes in a lung transplant program.
  2. Identify steps that can be taken to maximize posttransplant outcomes in lung recipients.

1:30 p.m.

Psychological Assessment and Intervention in Transplant, Ben J. Lippe, PhD

This presentation is designed to educate participants regarding the nature of psychiatric illness and related psychosocial factors in the context of solid organ transplant. The role of mental health professionals in transplant services, including an overview of associated treatments, will be discussed.

Learning Objectives:

  1. Describe the relationship between mental health and medical health.
  2. State the impact of psychiatric disease on transplant outcomes.
  3. Outline role of mental health professionals in transplant services.

2:00 p.m.

Immunosuppresant Medications: Quick Hits, Sarah Wright, PharmD and Lisa Fuller, PharmD

Posttransplant immunosuppression management has evolved substantially over the years; however, this remains a complex field. With the successes of immunosuppressive therapies come the obligations to tailor treatments to meet the individual patient’s characteristics and to balance the risks and benefits of these medications. Balancing the risk of rejection with the risk of drug toxicity remains a challenge for the medical community. This session will address and compare effective use of the most updated protocols for immunosuppression in solid organ transplantation.

Learning Objectives:

  1. State the advantages and disadvantages with using tacrolimus and tacrolimus extended release.
  2. Outline recent study updates with use of belatacept.
  3. Identify the benefits of eculizumab, bortezomib and rituximab for antibody rejection.
  4. Describe antifungal interactions with calcineurin inhibitors.

3:00 p.m.

Liver Transplantation: Evaluation, Selection and Allocation, Thomas Kerr, MD, PhD

This session will provide an overview of the evaluation, candidate selection and listing process for liver transplantation. The organ allocation system and current liver transplant outcomes will also be reviewed.

Learning Objectives:

  1. Describe the organ allocation system for liver transplantation.
  2. State the liver transplant candidate selection process.
  3. Discuss liver transplant outcomes.

3:30 p.m.

Cirrhosis and Hepatic Decompensation, Arji Mufti, MD

Learning Objectives:

  1. Explain the basic mechanisms of portal hypertension.
  2. Recognize the typical presentations of complications of portal hypertension.
  3. Review the management of complications of portal hypertension.
  4. Summarize the indications for liver transplantation in patients with decompensated cirrhosis.

4:00 p.m.

Update on Hepatitis C Virus (HCV), Shannan Tujios, MD

Hepatitis C infection is a global public health issue with an estimated 170 million people infected worldwide and 3 million–7 million infected in the U.S., making it the primary indication for liver transplantation and the leading cause of liver-related death. Historically, HCV treatment was limited to pegylated interferon with ribavirin that had many side effects with variable sustained viral response rates of 15–80 percent depending on genotype, patient characteristics and degree of fibrosis. Since 2011, the treatment of HCV has rapidly changed with the approval of direct acting antivirals. Now safe and effective oral treatment is available for many pre- and posttransplant patients with greater than 95 percent cure rate. This session will review the epidemiology of HCV and the evolution of therapies, including liver transplant, to manage and treat this viral infection.

Learning Objectives:

  1. Explain the epidemiology and natural history of HCV.
  2. Describe the rationale of liver transplantation for the treatment of HCV.
  3. Review optimal outcomes for HCV that can be achieved with well-tolerated, highly efficacious oral regimens.
  4. Recognize that the role of HCV in transplantation is changing with advent of new therapeutic options.

4:30 p.m.

Taking the Guesswork Out of Marginal Donors: How to Make Better Choices Today and in the Future, Malcom MacConmara, MD

The shortage of donor organs has led transplant programs to extend their donor criteria. The use of marginal donors provides an immediate expansion of the donor pool. However, in order to optimize outcomes, careful attention should be paid to match the most appropriate graft-recipient pair. This session will review the issues and concerns surrounding the use of marginal donors and will identify factors that influence outcomes for these grafts.

Learning Objectives:

  1. Summarize the complex and unique management issues required to optimize donors for liver transplantation.
  2. Describe the best strategies for marginal donors.
  3. Explain the novel method of liver machine perfusion in the assessment and utilization of donor livers.

 

Target Audience

These materials are intended ONLY for pharmacists and pharmacy technicians that attended "Transplantation in 2015: Advances in Solid Organ and Blood/Marrow Transplantation" held in Dallas, Tex., on Aug. 27, 2015.

The prerequisite to this process is completing the Transplantation in 2015: Advances in Solid Organ and Blood/Marrow Transplantation's Conference Post-Assessment and Evaluation. If there is a Prerequisite section above and the Status field is blank, click on 'Transplantation in 2015: Advances in Solid Organ and Blood/Marrow Transplantation' to open the Assessment and Evaluation.

Activity summary
Available credit: 
  • 7.25 ACPE - Pharmacists
Activity opens: 
08/27/2015
Activity expires: 
10/02/2015
Event starts: 
08/27/2015 - 8:00am EDT
Event ends: 
08/27/2015 - 5:00pm EDT
Rating: 
0
William P. Clements Jr. University Hospital
6201 Harry Hines Blvd.
Dallas, TX 75390
United States

Available Credit

  • 7.25 ACPE - Pharmacists
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