Wednesday: Overcoming Political Barriers

Prague serves as a showcase for the positive changes that have occurred in Eastern Europe following the demise of the iron curtain. You will be welcomed by President Lori West and Czech Republic Deputy Prime Minister and Minister of Foreign Affairs Karel Schwarzenberg, entertained by an historical perspective of Prague through the years and enlightened by a description of the successful development of a lung transplant program in Prague. Finally, you will be stimulated to consider the impact of politics on scientific advancement by internationally acclaimed physicist, commentator and essayist Lawrence Krauss.

Thursday: ISHLT Traditions

Following tradition, Thursday's plenary will include the annual Thoracic Organ Transplant and Mechanical Circulatory Support Registry Reports. Then we will be challenged as transplant professionals to aid in efforts led by the World Health Organization to raise awareness of access, safety and ethical issues in cell, tissue and organ transplantation by Luc Noel MD of the World Health Organization. The plenary session will close with a presentation of the Lifetime Achievement Award to Prof. Sharon Hunt for her many roles in Heart Transplantation Medicine beginning with its birth at Stanford University and continuing today as well as her ongoing contributions to the ISHLT.

Friday Morning: The Aging Imperative: Ethics, Economics and Resource Allocation

The aging of our population impacts health care in multiple domains and is increasingly affecting delivery of care to patients with heart and lung failure. Mi-Kyung Song PhD, RN, University of North Carolina, will teach us about how to help aging patients make health care decisions and Axel Rahmel, medical director of Eurotransplant, will provide a systems perspective. The session will also include presentations on aging and immunobiology, assesment of "frailty" in elderly patients and the ethics of allocation of scarce resources.

Friday Afternoon: New Horizons

Prepare for a glimpse of future research in key areas of our Society. Harald Ott, MD, Massachusetts General Hospital, will tantalize us with descriptions and images of bio-artificial organs. The session will continue with talks on the use of functional imaging to assess graft function, the future of sttem cell research and the pursuit of tolerance and will close with a discussion of the importance of pulsatile flow in mechanical circulatory support by Mandeep Mehra, MD.

Saturday: Incorporating Information Technology into Pre- and Post-Transplant Care

Information technology in health care is expanding in multiple dimensions, including personal and system-based electronic health records, the use of social networking to improve patient communication and the use of information technology to provide more efficient and effective care. Cleveland Clinic Chief Information Officer C. Martin Harris, MD, will provide a broad overview of the impact IT is having on health care, followed by presentations on the use of technology in the care of heart failure patients, those receiving mechanical circulatory support and transplant recipients.

Beginning with the pre-meeting symposia, joint symposia that bring together speakers and members from various disciplines will be spread throughout the program - a highlight will be two consecutive symposia: AMR Part 1: The ABCs of AMR: Antibodies, B Cells, and Complement and AMR Part 2: The DEFs of AMR: Detecting the Antibodies, Evaluating the Biopsy, and Finally, the Patient. These two sessions will bring together pathologists, immunologists and experts in clinical heart and lung transplantation. Other symposia will feature experts in pulmonary hypertension, heart failure and mechanical circulatory support to shed light on the right ventricle.

Pediatricians will share the podium with their adult colleagues in several sessions, including Management of the Failing Fontan Patient Across the Age Spectrum, Congenital Heart Disease: Pulmonary Hypertension Dilemmas in Pediatric and Adult Patients and MCS in Congenital Heart Disease & Pediatrics.

Highlights of sessions related to donor and organ management include an update on the use of ex-vivo techniques in Ex-Vivo Perfusion of Heart and Lungs - Why, With What and How?, a cutting edge session entitled, Thoracic Organ Donors: Optimal Management and New Avenues and finally a timely session co-sponsored by the infectious disease council - Risky Business: Infectious Risk in Donors and Recipients, featuring Camille Kotton, MD, Massachusetts General Hospital, presenting on The 'Well-Travelled' Donor: What are the Risks?

These sessions will provide attendees with important new information about managing donors and donor organs.

As one of the core disciplines of ISHLT, Heart Failure and Transplant Medicine will be among the most prominent topics discussed in Prague. Clinical handling of advanced heart failure and heart transplant patients will remain the nucleus of the six dedicated concurrent symposia, two of which have been designed to foster interactivity between panel discussants and the audience. However, the invited speakers will additionally provide a broad perspective towards the basic mechanisms of the pathological processes to understand practical applicability of molecular biology techniques, clinical relevance of the novel immuno-biology processes involved in graft rejection and a multidisciplinary outlook of patient's care, involving LVAD and pharmacological management of PH.

The cutting edge of cellular and antibody-mediated acute rejection will be covered in three consecutive Satellite Symposia. The first, Past, Present and Future of Cardiac Allograft Surveillance will deal with the changing patterns and clinical manifestations of acute rejection, the role of endomyocardial biopsy monitoring in the modern era and the clinical reliability of novel non-invasive tools based on molecular biology techniques. The second and third symposia, focusing on AMR, will discuss novel targets for treatment and updates of the pathologcal classification.

Thursday's Satellite Symposium session, Tough Situations in Cardiac Transplantation, will offer the audience the possibility to interact with an expert panel chaired by Mandeep Mehra on two controversial clinical scenarios in the management of long-term heart transplant recipients. A novel perspective on CAV, moving beyond the mere concept of coronary intimal thickening, will be provided in the Satellite session, Large and Small Vessels Disease in Cardiac Transplantation, covering the concept of vascular remodeling, morphology and function of coronary microvasculature and therapeutic targets and tools.

On Friday, the Satellite session, The Leading Edge of Immunosupporession in Heart Transplantation: Evidence, Perspectives and Clinical Practice, will grant insights from clinical trials and clinical practice of modern immunosuppression. This rich international menu of concurrent symposia, seasoned by oral abstract sessions, is expected to fully feed transplant cardiologists' hunger for cutting-edge education, within the heart of old Europe.

Another of the core disciplines at the foundation of our society, management of respiratory failure and pulmonary replacement therapy, will be prominent topics throughout the meeting. In addition to the pulmonary aspects of antibody mediated rejection to be included in the pre-meeting AMR sessions, the first pre-meeting symposium devoted to lung transplantation, Evolving Concepts of Chronic Lung Allograft Dysfunction, will review new concepts of chronic lung allograft dysfunction and will reflect some of the conclusions and recommendations reached by the joint ISHLT / ATS / ERS task force on care of the lung transplant recipient. Advances in Pulmonary Transplant Surgery, another pre-meeting symposium, will include presentations on airway complications, mechanical bridging and ex-vivo lung perfusion.

Concurrent symposia on Thursday and Friday include the session, Special Considerations: Cystic Fibrosis and Lung Transplantation, which will review the complicated microbiology, surgical considerations and psychosocial issues associated with transplant of the CF patient. An international review of Lung Transplantation for Pulmonary Arterial Hypertension will focus on the impact that regional variability in listing status, organ allocation and the type of organ transplantation have on outcomes, and finally a session on Challenges in Pediatric Lung Transplantation that will close with a presentation on transition of the pediatric lung transplant recipient to adult care.

Infectious Diseases will be significantly highlighted during a variety of symposia during the meeting. In CMV & Beyond, we will highlight emerging viruses in thoracic transplantation as well as discuss developing issues with cytomegalovirus. Bad Bugs - What Can We Do? includes discussions of the impact of mult-drug resistant gram negative organisms, VRE and MRSA and Clostridium difficile, with a focus on prevention. Infectious diseases will also be woven into sessions sponsored by other councils, including talks on infections in Mechanical Circulatory Support and in transplant candidates with Cystic Fibrosis. Finally, we will have the opportunity to evaluate the Risky Business of Transplantation, focusing on candidates and donors with chronic hepatitis and history of international travel.

The 2012 NHSAH program highlights include a presentation for Incorporating Information Technology into Pre- and Post-Transplant Care in the plenary session titled, Using Technology to Promote Self-Monitoring and Health Outcomes after Transplantation. The NHSAH council also played a major role in developing the plenary Aging Demographic Imperative: Ethics, Economics & Resource Allocation as well as three key symposia.

Children and adolescents frequently face significant developmental challenges from the time of transplant through the time they transition to adult programs. Neurocognitive, Psychosocial and Behavioral Issues in Children and Adolescents is a pre-meeting symposium jointly facilitated by pediatric and nursing councils to address non-clinical issues (psychosocial, behavioral and neurocognitive) in children after thoracic transplantation.

Caregivers are a crucial component to successful outcomes for our patients, thus in the Focus on Caregivers - Investing in our Patients' Future symposium, a panel of experts will outline unique approaches to address needs of caregivers so they can continue to provide optimal care to transplant recipients and MCS patients.

In recognizing that transplantation is a chronic condition, development of self-management strategies is a key component to improving long-term outcomes post thoracic transplantation. Presenters in the symposium Self Management in End-Stage Heart-Lung Disease and Transplantation will describe important principles of 'self-management,' including management of the medical and pharmaceutical regimens, emotions and new life roles for both adult and pediatric patients.

The mechanical circulatory support field continues to grow, and so will its representation at the 32nd Annual Meeting and Scientific Sessions. A comprehensive MCS program will start on Tuesday with the ISHLT Academy dedicated to mechanical support.

During pre-meeting symposia, didactic sessions will include Optimizing Outcomes in Patients with Right Heart Failure in Need of Mechanical Circulatory Support, providing an overview of different RV risk assessment approaches before LVAD implant. Cardiogenic Shock Before and After Heart Transplantation will review options, from ECMO to total artificial heart, that are available for patients in severe cardiogenic shock before and after heart transplantation. New Devices, New Approaches will explore new developments in LVADs and their clinical applications. Current approaches to MCS in children will be highlighted in MCS in Congenital Heart Disease & Pediatrics. The final pre-meeting symposium will be The Longer The Better - Chronic Medical Management of MCS focusing on how to optimize long-term MCS.

During the main meeting, the MCS concurrent symposia on Thursday and Friday will include MCS: When Is It Too Soon or Too Late? providing the latest information on patient selection for device therapy at both ends of the heart failure spectrum - specifically when is a patient too sick to receive a VAD and how early in the HF disease trajectory can we consider VAD implant, and on Friday, MCS Recovery - How Do We Get There, intended to showcase our understanding of this process and possible approaches that could make myocardial recovery a treatment goal.

A number of abstract sessions, mini-orals and poster sessions with focus on MCS will provide ample opportunity for discussing new research as well as pondering old problems. Finally, topics with direct relevance to the MCS field will be addressed at a closing plenary session titled, Incorporating Information Technology into Pre- and Post-Transplant Care.

Forget the sight-seeing! Every day of the 2012 scientific meeting in Prague is packed with sessions of interest to the pediatric transplant specialist. This year's symposia promote crosstalk between specialists of shared interests through collaborative sessions related to pulmonary hypertension in the session, Congenital Heart Disease: PH Dilemmas in Pediatric and Adult Patients, lung transplant challenges specific to the child and young adult in the session, Challenges in Pediatric Lung Transplant, pediatric mechanical circulatory support in everyday practice in the session, MCS in Congenital Heart Disease & Pediatrics as well as not-so-basic information needed for a basic understanding of transplant immunology in infants. You may discover some gems about managing the adolescent transplant patient's cognitive, psychosocial and behavioral dilemmas in the Czech Republic that can be more broadly applied to other adolescents in your life - Neurocognitive, Psychosocial and Behavioral Issues in Children and Adolescents.

And just when you need respite from the castle-laden landscape and the never-ending night life of Eastern Europe, the featured session on the failing Fontan will entice you back to matters of importance with the session, Management of the Failing Fontan Patient Across the Age Spectrum. Whether your goal is to decide once-and-for-all how to treat AMR or to reach a consensus in pediatric transplantation with IPTA, your trip to the ISHLT meeting in Prague will be an enriching experience.

Again this year, the members of the Program Committee representing pulmonary hypertension have put together a diverse and exciting series of pre-meeting and concurrent symposia highlighting cutting edge patho-physiology of, and treatment for, advanced pulmonary hypertension. Invited speakers include key members of our society complemented by some of the leading authorities in the world.

The meeting will open with three pre-meeting symposia devoted to aspects of pulmonary hypertension. First, Potpourri of Special Topics in Pulmonary Hyptertension will include a series of topics on pulmonary hypertension that are less understood and of interest to cardiologists, pulmonary and critical care specialists, anesthesiologists and surgeons, including a presentation on Schistosomiasis: Possibly the Most Common Worldwide Cause of Pulmonary Hypertension. A state-of-the-art understanding of right ventricular (RV) function in health, exercise, resting pulmonary hypertension and right heart failure will be presented in The Right Ventricle and Pulmonary Vascular Load in Health and Disease. The pre-meeting symposia will close with Congenital Heart Disease: Pulmonary Hypertension Dilemmas in Pediatric and Adult Patients providing useful information on the management of patients with pulmonary hypertension associated with congenital systemic to pulmonary shunts, particularly those with unrepaired shunts.

Concurrent symposia on Thursday and Friday will open with a worldwide tour of Lung Transplantation for Pulmonary Arterial Hypertension - A Review and Panel Discussion, focusing on the impact that regional variability in listing status, organ allocation and the type of organ transplantation (lung versus heart-lung) have on outcomes. On Friday, Following the RV Through Thick and Thin will provide a thorough overview of the problem of RV dysfunction in patients with CHF due to LV diseases, with a pathophysiological overview of PH secondary to LV dysfunction and finally Pulmonary Hypertension in Chronic Parenchymal Lung Diseases: Does it Matter? will highlight increasing recognition of pulmonary hypertension as a serious complication of chronic obstructive and interstitial lung diseases.

Again this year, pathologists will be front and center with two pre-meeting symposia focused on all aspects for antibody mediated rejection in clinical heart and lung transplantation - AMR Part 1: The ABCs of AMR: Antibodies, B Cells, and Complement and AMR Part 2: The DEFs of AMR: Detecting the Antibodies, Evaluating the Biopsy, and Finally, the Patient. The pre-meeting symposia will open with Past, Present and Future of Cardiac Allograft Surveillance, a session intended to review the usefulness and pitfalls of endomyocardial biopsy monitoring in current clinical practice, including practical information regarding the use of genomics and proteomics-based methodologies.

Concurrent symposia on Thursday and Friday will include Large and Small Vessels Disease in Heart Transplantation reviewing the importance of pathological features involving large epicardial and small intramyocardial vessels in cardiac allograft vasculopathy and a case-based discussion entitled, Solving the Enigmatic: Cases in Heart and Lung Transplantation.

This year the Program Committee made an effort to complement important clinical symposia with presentations from menbers of the newly formed Basic Science and Translational Research council. This is particularly evident in the sessions entitled, Past, Present and Future of Cardiac Allograft Surveillance and AMR Part 1: The ABCs of AMR: Antibodies, B Cells, and Complement. Another pre-meeting symposium, Innate Immunity in Cardiothoracic Transplantation will provide information on emerging innovative modalities for studying innate immunity and the concurrent symposium Coagulation and Transplantation - The Clot Thickens will review the role platelets and complement may play in immune stimulation following thoracic transplantation.

Basic science and translational research will also be highlighted in plenary sessions on stem cells (Sonja Schrepfer) and tolerance (Sophie Brouard) as well as the Joint ISHLT/ESOT Symposium including presentations on T-regs (Carla Baan), clinical experience with belatacept and the relationship between ABO incompatability and HLA antibodies.

Finally, the Caves Award competition session will continue to highlight original research by our young academic scientists, who present their most compelling experimental and clinical research to a jury of senior scientists and interested members.

Members of the new Pharmacy and Pharmacology Council will be featured Thursday morning in the inaugural symposium in a series entitled A Lifecycle Journey in... sponsored by the ISHLT Pharmacy and Pharmacology Council. This series, focusing on therapeutic aspects that uniquely involve emerging or established knowledge in the pharmacology and pharmacy, envisions using an enduring case to create a panel facilitated and an audience supported best practice based discussion at predefined key "journey intervals." In this session the focus will be on the lifecycle of Advanced Heart Failure and Cardiac Transplantation with special emphasis on the "journey points" of Mechanical Circulatory Support and anticoagulation, post-transplant development of Antibody Mediated Rejection and late complications that demand innovative immunosupporessive strategies.

Again this year, Junior Faculty and Trainees are encouraged to submit cases for the popular Clinical Case Dilemmas in Thoracic Transplantation session where tough cases are presented by junior faculty to expert discussants (these cases must be submitted via the standard abstract submission process, the deadline is November 18, 2011).

We are also planning to reprise the "Mentor Lunch" on Thursday. In this setting, junior faculty and trainees can learn about Getting Your Next Job, Balancing Work and Family and other topics of special interest (pre-registration is required and limited).