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Looking Back (and Forward to Nice) - Transplant ID Highlights from the 37th Annual Meeting and Scientific Sessions

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Stephanie Pouch, MD
The Ohio State University
Columbus, OH, USA

If I thought the job of summarizing the Meeting's ID highlights was hard last year, I realized after about ten minutes that I was in for a welcome challenge this time around. Just like the Padre's home opener, ISHLT hit this one out of the park. Was it the warm and sunny San Diego weather? Perceptively larger attendance? Session topics that were so exciting you had a hard time choosing which one to attend? In my mind, it was all of the aboveā€¦and then some. While it is impossible to summarize all of the presentations and the incredible work of all of my colleagues in a few short paragraphs, one theme seemed to permeate my thoughts as I left San Diego - global challenges and opportunities.

The Meeting opened with the ISHLT Academy Core Competency Course in Infectious Diseases in Thoracic Transplantation and MCS. Led by Drs. Martha Mooney and Shahid Hussain, this hugely successful course provided a foundation of the overarching principles of infectious disease concerns in cardiothoracic transplantation and mechanical circulatory support. Universally, I believe that the more we learn, the more questions we ask. Along these lines, Drs. Mooney and Hussain certainly laid the groundwork for more international collaboration regarding evolving issues in transplant ID and, in alignment with the goals of the ISHLT Academy, complemented "the ISHLT's existing activities in the promulgation of new science, registry analysis, guideline statements, and monograph series." We really could not have gotten off to a better start.

Another highlight of the annual meeting was Ongoing Challenges in Transplant Infectious Diseases, a joint symposium supported by a collaborative effort between ISHLT and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Members from both international organizations deftly described ongoing challenges we face on a daily basis, including non-cultural methods for the diagnosis and prevention of invasive fungal infections, the role of inhaled antimicrobials in the management of pneumonia, management issues for thoracic organ recipients on ECMO, hepatitis C in donors and thoracic transplant recipients, and experience with HIV in thoracic organ transplantation and MCS. The symposium also raised new questions about the role of EBV and annellovirus viremia as markers of infection risk in lung transplant recipients.

The global theme continued with Around the World in 80 Days: Infectious Challenges in Cardiothoracic Transplantation, in which we gained international perspectives on zika virus infection in solid organ transplant recipients, hepatitis B in thoracic organ recipients, screening and management of latent and active tuberculosis, and advice for organ transplant recipients planning international travel.

Finally, after a description of invasive M. abscessus infections in heart transplant recipients during Cutting Edge Updates in Infectious Diseases, the global and ongoing challenges posed by this pathogen were highlighted during Taming of the Shrew: Mycobacterium abscessus in Lung Transplantation. Not only did we learn more about the epidemiology and modes of transmission of the pathogen, implications for infection control measures, and challenges related to diagnosis, but rather we gained expert guidance on the pre-transplant management of patients with M. abscessus infection and colonization, and effective therapies for M. abscessus infections. Gregory Snell and Paul Corris concluded with a witty debate about the safety of lung transplantation in patients infected or colonized with this pathogen. No matter your take on the issue, M. abscessus is here to stay (at least for the foreseeable future).

Overall, I left San Diego with more questions than answers, which I believe is reflective of an incredible meeting. As Vincent Valentine said to me one evening, "it's about asking the right questions," and ISHLT is doing just that. I have always thought that one of the greatest (and obvious) strengths of the organization is its international focus, and as we collaborate to find answers to our questions, we will continue to improve outcomes for our patients. And this is really what it is all about. Thank you so much to all of my wonderful colleagues across all disciplines - you continue to inspire me on a daily basis, and I look forward to seeing you next year in Nice. ■

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

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