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Summary of ISHLT 2016 JFTC Focus


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Jorge Silva Enciso, MD
Univeristy of California San Diego
San Diego, CA, USA
Jsilvaenciso@ucsd.edu



The 36th ISHLT meeting was success in diversity of presenters discussing their work. The major themes from this year sessions focused on LVAD complications. An enormous recognition went to those adverse events that affect outcomes, particularly stroke, right heart failure and device infections. Between both types of LVAD currently on the market (HeartMate and HeartWare), both continue to show high rates of stroke associated with high mortality from hemorrhagic CVA. Even though technology today is far better than earlier devices of yesterday, the drivers for these events are still unclear. Regarding right heart failure (RHF), a new concept was introduce quantifying the spectrum of RHF risk based on duration of inotropic support and its relationship to outcomes. Those with prolonged inotropic support (≥ 21 days) or unplanned RVAD had an increased mortality at 3 and 6 months. This knowledge further contributes to the struggle of risk stratifying the moving target of RHF pre and post-implant with more studies needed to safely predict RHF. However, a consistent theme showed that markers of overall severity of illness including end organ dysfunction, unstable hemodynamics and prior sternotomy continue to predict the need for biventricular support. On the other hand, LVAD Infections were seen as a frequent cause of readmission over time and had a significant reduction in functional performance as noted by the Mayo and ENDURANCE study groups.

The impact of these adverse outcomes did not however effect Quality of life (QOL). Several discussants presented their work on improvements in functional status and QOL on LVAD therapy. Data from the ENDURANCE trial, INTERMACS and ROADMAP trial confirmed this knowledge. Depression and anxiety improved significantly after LVAD implant, and caregiver burden post-LVAD was less than expected. The latter was a great point of discussion among attendees with many expressing their patient experience to be different.

During the sessions, there were many council meetings advocating for ISHLT member participation and collaborate with others to expand the society's mission. Of particular interest, the I2C2 council discussed working with ISHLT members from Latin America to increase their presence in future meetings by helping to establish a registry for future studies. Many Latin America members were present and expressed their eagerness to participate and create coalitions with other Latin countries to fulfill the I2C2's goal.

On a final note, I am proud to say that many junior faculty were chairing sessions this year. This was a testament of the JFTC (Junior Faculty Training Council) active contribution to the sessions. If you are interested to participate, please step forward or please stand up!

Washington was an excellent host to this year meeting and a great city that offers the diversity and culture that equally reflects the status of ISHLT members. I eagerly await for next year's program in San Diego (shameless plug since I live here) where not only new research and approach to patient care will be discussed but also you'll get a chance to experience the California warmth we offer on this side of the globe from the other side of the United States. See you in Sunny San Diego! ■

Disclosure Statement: The author has no conflicts of interest to disclose.




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