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links imageIN THE SPOTLIGHT:

ISHLT 2014 in Sunsational San Diego!

Featuring meeting highlights in:

•  Pathology
•  Pharmacy & Pharmacology
•  Junior Faculty & Trainees

The ISHLT is very excited to return to the beautiful, sunny city of San Diego in April 2014 for the ISHLT 34th Annual Meeting & Scientific Sessions to be held at the Manchester Grand Hyatt hotel. A wealth of information about the meeting can be found on the Annual Meeting website, including Abstract Submission, Registration & Housing information, the Daily Timetable, the Preliminary Scientific Program, the Schedule At-A-Glance, and much more. Please note that the Annual Meeting begins on Thursday, April 10, one day later than usual, and concludes at mid-day on Sunday, April 13.

Since this month's newsletter focuses on Pathology, Pharmacy & Pharmacology, and Junior Faculty & Trainees, below are highlights of the upcoming meetings related to these disciplines.


Pathology will provide some very important content again at ISHLT 2014 in a number of symposia. Lung allograft dysfunction occurs in many different ways; these present and progress in differing fashions; treatment, although not well developed, could be different between different types. Thursday's Pre-meeting Symposium 10: The Many Faces of Chronic Lung Allograft Dysfunction will address these issues.

Events and mechanisms in T-cell mediated immunity are distinct from those of B-cell mediated immunity, but the two are not mutually exclusive. Saturday's Sunrise Symposium 10: Exploring Interactions Between Cellular and Humoral Immunity in Cardiac Allograft Rejection deals with interactions between the two arms of the immune system at the basic science level (using NK cells and innate immunity as one possible contributor) and reviews what is available with respect to "mixed rejection" in terms of outcomes and management.

ISHLT 2014

• Annual Meeting website
• Academy website
Online Registration
• 2014 Preliminary Program

REMINDER: The Annual Meeting begins on Thursday (one day later than usual) and concludes mid-day on Sunday.

The Pathology Scientific Council Meeting will take place on Saturday, April 12, from 12:05 PM - 12:55 PM during the lunch break.

Sensitization (circulating HLA-antibodies) in patients awaiting heart transplantation may lead to prolonged waiting times and possibly increased complications/death while on the waiting list. Saturday's Concurrent Symposium 29: Approach to the Highly Sensitized Patient Awaiting Heart Transplantation is designed to provide attendees with practical information and strategies to manage sensitized patients awaiting heart transplantation. Recent research publications and program experience will inform this session.


The Pharmacy & Pharmacology content of the Annual Meeting kicks off on Thursday with Pre-meeting Symposium 7: Making Bloody Sense of Anticoagulation. Anticoagulation is common in most practice areas represented by the ISHLT membership. Although most clinicians use anticoagulation therapies, questions often arise around how these medications compare with others within this class, interpretation of labs testing, and the function of new and future medications. The goals of this symposium are to discuss: 1) where anticoagulation therapy has been, 2) the status of anticoagulation in 2014, and 3) appropriate interpretation and application of anticoagulation monitoring; and then use this information in discussion of MCS recipients and their thrombotic and bleeding risk after implantation where multiple different regimens, goals and management strategies that employed across centers and between devices.

Pre-meeting Symposium 15: Bad Bugs: Optimize the Drugs! combines brief illustrative case presentations followed by state-of-the-art lectures reviewing issues and controversies in antiviral, antibacterial, antifungal and antimycobacterial therapeutic drug monitoring (TDM). Although there is a small amount of published information on TDM and azole antifungal agents in heart lung transplantation, the antibacterial and antiviral drugs have been very neglected. links imageInappropriate dosing may lead to treatment failure, toxicity and the development of resistant organisms, both of which can be catastrophic in the transplant setting.

The Pharmacy & Pharmacology Scientific Council Meeting will take place on Thursday, April 10, from 12:30 PM - 1:30 PM during the lunch break.

The infectious disease sessions at ISHLT traditionally have focused on adults rather than children. Some of the pediatric responses to infections are quite disparate from those of adults. Pre-meeting Symposium 23: State of the Art Update on Infectious Disease Issues in Pediatric Thoracic Transplantation will provide a state of the art update based on the latest data in pediatrics.

Friday morning begins with Sunrise Symposium 5: What You Always Wanted To Know About LISH (Laboratory Tests, Infectious Agents, Special Situations, Hidden Infections) But Were Afraid To Ask. In the field of infectious diseases there are many accepted standards for treatment and diagnoses. However we do not always know the real explanation for them nor do we question them. This symposium will attempt to clarify several main topics in ID from laboratory to therapy.

After the successful symposium, "A lifecycle journey in cystic fibrosis and lung transplantation" at ISHLT 2013, we propose to continue this innovative session for the 2014 meeting. Traditional symposia are presented either in pure didactic tracks or cases with panel discussions during Friday's Concurrent Symposium 25: A Lifecycle Journey in Pulmonary Hypertension. This series is a practical hybrid depicting an enduring case interspersed with a best practice based discussion at predefined key "journey intervals." The symposium will be rounded off by a panel assisted and audience supported anchoring discussion. The lifecycle of pulmonary arterial hypertension will include special emphasis on 4 "journey points:" 1) Appropriate evaluation and diagnosis, 2) Management of acute decompensated PAH, 3) Long term management, links imageand 4) Invasive options for bridging and palliation. The focus of this series will be on therapeutics that uniquely involves emerging or established knowledge in the pharmacology and pharmacy aspects of the interval disease states or situations.

Saturday begins with Sunrise Symposium 7: The Effects of Prostaglandin Therapy in Pulmonary Arterial Hypertension: The Seen and Unseen Risk/Benefit Profile. Although treatments have improved symptoms, exercise tolerance, and quality of life for patients with pulmonary arterial hypertension, PAH remains a progressive, life limiting disease. The purposes of this symposium are to raise awareness of the physical (seen) and psychological (unseen) effects of IV prostaglandin, the current mainstay for treatment for PAH, culminating in a case presentation/panel discussion.

Sensitization (circulating HLA-antibodies) in patients awaiting heart transplantation may lead to prolonged waiting times and possibly increased complications/death while on the waiting list. Saturday's Concurrent Symposium 29: Approach to the Highly Sensitized Patient Awaiting Heart Transplantation is designed to provide attendees with practical information and strategies to manage sensitized patients awaiting heart transplantation. Recent research publications and program experience will inform this session.


The Junior Faculty & Trainee Council (JFTC) submitted 14 proposals for symposia for ISHLT 2014, most of which were developed jointly with other councils. The JFTC is excited to have had 6 of these symposia selected for ISHLT 2014.

Transition is defined as "the process by which adolescents and young adults with chronic childhood illnesses are prepared to take charge of their lives and their health in adulthood". Effective transition programs have the potential to decrease morbidity and mortality associated with transfer of care and can improve quality of life. links imageThursday's Pre-meeting Symposium 6: Joint ISHLT/IPTA Symposium: Here They Come: Preparing Pediatric Patients For Transition To Adult Care will discuss issues essential to successful transition of pediatric patients to adult care, including patient and family challenges, as well as potential strategies/interventions to meet these challenges.

Mechanical circulatory support, through the advent of continuous-flow left ventricular assist devices, has dramatically altered our management of patients with advanced heart failure. Despite over a decade of experience with continuous-flow pumps, we only have a basic understanding of the human cellular and molecular response to mechanical support. Gene expression, metabolomics and other translational techniques should provide some key insights into the human response to continuous blood flow and will perhaps lead to strategies to predict and prevent the morbidities of VAD therapy. Finally, the "holy grail" of MCS is myocardial recovery which may indeed involve therapy with stem cells, but only if aided by an integrated analysis of the entire human genome and its downstream transcriptional and translational products. Pre-meeting Symposium 13: Drilling Down on Myocardial Recovery—Basics and Clinical will review our current understanding of translational research in the setting of MCS with an emphasis on its clinical utility and translation.

Friday's Sunrise Symposium 2: Under Too Much Pressure: Challenging Cases in Pulmonary Hypertension Management is meant to be a multidisciplinary symposium (cardiology, pulmonary, PH) discussing management of challenging patients who have complicating pulmonary hypertension. Three cases will be presented by junior faculty members. The case presentations will include challenges to the discussants (in an open forum) regarding next steps in evaluation, management, etc of pulmonary hypertension. links imageThe objectives of the symposium are 1) Evaluation and management of challenging cases in PH, 2) Discussion of controversial techniques in PH evaluation, 3) Pre- and post-transplant evaluation of patients with PH, and 4) Post-transplant pharmaceutical management of cardiac transplant patients with preexisting PH.

Endothelial function is increasingly recognized as a general barometer of health. There is extensive data that endothelial function is impaired in patients with heart failure. and it may be a marker of development of allograft vasculopathy in transplanted patients. A better understanding of the pathophysiology of endothelial dysfunction in heart failure, VAD and transplanted patients, the methods of endothelial dysfunction assessment, and its relation to outcome following VAD and transplant is crucial for specialists caring for patients undergoing advanced heart failure management. It is also critical for scientists working in the field of vascular physiology and outcomes research to understand the interaction between the different modalities and endothelial function in order to further enhance research in this arena. The first discussions in Sunrise Symposium 3: Endothelial Dysfunction in Advanced Heart Failure, Mechanical Circulatory Support, and Heart Transplant: It's a Pipe and Pump Issue will provide a general overview of the pathophysiology of endothelial dysfunction. The subsequent talks will provide in depth analyses of the development, treatment, and morbidity of endothelial dysfunction development, treatment, and morbidity in patients with heart failure, transplant, and MCS.

Saturday's Concurrent Symposium 28: JHLT at ISHLT: The Year in a Capsule will summarize the best research presented in the Journal of Heart and Lung Transplantation.

And finally, the JFTC is planning a return of the popular concurrent abstract session, Clinical Case Dilemmas in Thoracic Transplantation.

The Junior Faculty Mentor Lunch will take place on Thursday, April 10, from 12:15 PM - 2:00 PM. The Junior Faculty & Trainees Council Meeting will take place on Friday, April 11, from Noon - 1:00 PM.

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Prior to the Annual Meeting, the ISHLT will be conducting five Academies. The first two will be held simultaneously on Monday and Tuesday, April 7-8, at the Loews San Diego Bay Resort in Coronado, California:

  1. ISHLT Academy: Core Competencies in Mechanical Circulatory Support
  2. ISHLT Academy: Masters Course in Mechanical Circulatory Support

Then, on Wednesday, April 9, the ISHLT will host three additional Academies simultaneously at the Manchester Grand Hyatt Hotel in San Diego:

  1. ISHLT Academy: Core Competencies in Basic and Translational Science
  2. ISHLT Academy: Core Competencies in Heart Failure and Cardiac Transplant Medicine
  3. ISHLT Academy: Core Competencies in Nursing, Health Science, and Allied Health

Detailed information about each academy is available on the ISHLT Academy website, including course descriptions, registration and hotel information, and scientific programs.

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