The Newsletter of the International Society for Heart and Lung Transplantation
Summer 1998
Volume 1, Issue 1

ISHLT Initiates Newsletter

This is the first issue of what we hope will become a regular publication and member service, The Society News. Some of you may recall that the Society News used to be published in the back of each issue of the Journal of Heart and Lung Transplantation. We found that this means of communicating news of interest to the members was not a very successful one. Thus, the 24 Society News pages in the JHLT have been given to the Editor for her use in publishing manuscripts, and this newsletter will be the new communication vehicle between the Society and its members.

We anticipate that The Society News will include information about activities of the Scientific Councils, information from the various International Registry Representatives about changes in the field of transplantation within their countries, news about upcoming and past ISHLT events, and other pertinent and useful information. We are eager to know what information you would like to receive. Please send us your comments and suggestions. We welcome them.

Norman Shumway Receives Lifetime Achievement Award

At the 1998 Annual Meeting, the Board of Directors and members of the ISHLT honored Norman Shumway with the ISHLT Lifetime Achievement Award, in recognition of his unsurpassed, lifelong contributions to the field of transplantation. The Annual Meeting concluded with a presentation by Dr. Shumway on the history of transplantation, a talk which most considered to be the highlight of the meeting.

New Board Members and Officers Elected

At the ISHLT Annual Business Meeting, the Society members voted for the following individuals as new members of the Board of Directors:

President-Elect

Robert Kormos, MD
University of Pittsburgh Medical Center, Pittsburgh, PA.

Directors

Linda J. Addonizio, MD
Columbia Presbyterian Medical Center, New York, NY

Marshall Hertz, MD
University of Minnesota, Minneapolis, MN

Stephan Schueler, MD
Cardiovascular Institute, Dresden, Germany

Lynne W. Stevenson, MD
Brigham and Women’s Hospital, Boston, MA

Susan Stewart, FRCPath
Papworth Hospital, Cambridge United Kingdom

Also at the Annual Business Meeting, Alan Menkis, MD, FRCS(C) succeeded to the position of President of the Society.

The members of the Board of Directors and the Society extend their heartfelt thanks to the outgoing members of the Board of Directors who have volunteered their time and energy over the past three years on behalf of the Society. Outgoing members of the Board are: William Baumgartner, MD; Anne Keogh, MD, MBBS; Jochum Prop, PhD, MD; James B. Young, MD.

Annual Business Meeting Minutes

The ISHLT Annual Business Meeting was called to order by President Leslie Miller at 1:30 pm on Saturday, April 18, 1998, in the Sheraton Chicago Hotel, Chicago, IL. Secretary-Treasurer Mark Barr recognized a quorum.

President’s Report: President Miller reported on the recent decisions made by the Board of Directors. (These decisions are outlined in detail elsewhere in this issue of the newsletter.) He then thanked James Young for the excellent scientific program he had put together and to the Board for helping to make his term as President as pleasurable one.

Secretary/Treasurer’s Report: Secretary/Treasurer Barr reported that the Society was in a very healthy financial position. He reported that annual income in 1997 exceeded $1,500,000, representing a more than 650% increase since 1987. He stated that net income (annual profit) for 1997 was approximately $260,000 and that the Society’s fund balance (net worth) is now over $950,000. He added that the goal of the Society is to reach a fund balance of $1.5 million, which would serve as a financial cushion for the Society should revenues drop in the future, and which would enable the Society to begin funding research grants and other activities out of interest and investment earnings rather than out of annual program and dues revenues.

Editorial Board Report: President Miller advised the members that the Editor, Dr. Costanzo, could not attend the Business meeting. He thanked Dr. Costanzo and the Editorial Board for their efforts over the years and for their success in raising the stature and quality of the Journal of Heart and Lung Transplantation.

Bylaws Changes - President Miller advised the Society members that the Board had voted to propose a Bylaws amendment to increase the number of voting Board members by two to 15. He stated that the increase in Board members would result in better representation on the Board of the many geographies and specialties present among the members of the Society. A motion was made and seconded to approve the proposed Bylaws change to increase the number of voting Board members to 15. The motion carried.

Elections - President Miller presented the following slate of nominees for the incoming Directors and Officers: President Elect: Robert Kormos, MD

Director: Linda Addonizio, MD

Director: Marshall Hertz, MD

Director: Stephan Schueler, MD

Director: Susan Stewart, FRCPath

Director: Lynne Stevenson, MD

President Miller requested that all members cast their votes by written ballot using the ballot sheets provided. The 6 nominees were elected by the members by an overwhelming majority.

Grants/Awards Committee Report - Dr. Alec Patterson announced that the winner of the Caves Award, a $1,000 prize for the best scientific presentation by a resident/fellow, was Carla C. Baan, MD, of University Hospital, Rotterdam-Dijkzigt, The Netherlands, for her presentation entitled, "Anti-CD25 Therapy Reveals the Redundancy of the Intragraft Cytokine Network After Clinical Heart Transplantation".

Dr. Patterson then announced the winners of the six $25,000 transplant research fellowship grant awards. These are listed in detail elsewhere in this issue.

Recognition of Outgoing Board Members - On behalf of the Society members and the Board of Directors, President Miller extended his sincere thanks to outgoing Board members William Baumgartner, Anne Keogh, Jochum Prop, and James Young, for their dedication to the Society and their service as Board members for the past three years. He then welcomed Alan Menkis as the new President of the Society and passed him the gavel. Dr. Menkis, in turn, expressed his thanks to Dr. Miller for his accomplishments as President and for his service to the Society and presented him with an honorary gavel.

There being no other business, the meeting was adjourned.

ISHLT Board of Directors Meeting Summary

Following are the significant decisions made by the Board of Directors at their meeting April 14-15, 1998, at the Sheraton Chicago Hotel, Chicago, IL.

  • The Board voted to propose a Bylaws change to make the Grants/Awards Committee a standing committee of the Society. This Bylaws change will be presented to the membership for a vote at the April, 1999 Annual Business Meeting.
  • A site inspection of the year 2000 meeting facilities in Osaka, Japan will be made this summer.
  • The 1998 Fall Education Meeting will be on the topic of Coronary Allograft Vasculopathy and will be held in Washington, DC, September 25-27.
  • The 1999 Fall Education Meeting will be on the topic of Ventricular Assist Devices, will be chaired by Robert Kormos, and will be held in Europe at a site to be determined.
  • The Board voted to propose a Bylaws change to make the Education Committee a standing committee of the Society. This Bylaws change will be presented to the membership for a vote at the April, 1999 Annual Business Meeting.
  • The Board voted to consider the following cities for the 2002 Annual Meeting, which will be held in North America: Philadelphia, Atlanta, Orlando, Washington DC, Baltimore, and Boston. After several years of meetings on the Pacific Rim, the Board felt it time to meet on the East Coast to reduce travel time and expenses for the European members.
  • The Board voted that authors of Featured Abstracts would be very strongly encouraged to submit a manuscript to the Journal of Heart and Lung Transplantation, and authors of Caves Award Candidate Abstracts would be required to submit a manuscript to the JHLT.
  • The Board voted to propose a Bylaws change to make the Foundation Committee a standing committee of the Society. This Bylaws change will be presented to the membership for a vote at the April, 1999 Annual Business Meeting.
  • JHLT Editor Maria Rosa Costanzo announced her intention to not seek reappointment of her position for another 5 year term. The Board voted to engage in a search process to find an incoming Editor.
  • The Board voted to appoint Jeffrey Hosenpud to a second 5 year term as Medical Director of the ISHLT Registry of Heart and Lung Transplantation.
  • The Board voted to renew its contract with the United Network for Organ Sharing for the collection and analysis of all non-US Registry data.
ISHLT Awards 6 Research Grants

ISHLT is pleased to announce that, out of 40 applicants, 6 individuals have been selected to each receive a $25,000 transplant fellowship research grant. The 1998 grant recipients and the titles of their research projects are listed below. We are most grateful to the corporate sponsors who provided funding for these grants.

We are also pleased to announce that this year marked the first time that ISHLT has awarded a research grant funded entirely by the Society. This year’s award went to Scott Ross. It is a goal of the Society to channel Society funds into transplant research and education, and we intend to continue to award ISHLT-funded grants in the future. We anticipate that the ISHLT-funded grants will increasingly be used to encourage research in areas of specific interest to the Society.

The next deadline for grant applications is February 1, 1999. Applications may be obtained from the ISHLT Headquarters Office. We anticipate awarding a minimum of four $25,000 research grants in 1999.

1998 ISHLT Transplant Research Fellowship Grant Recipient:

Scott D. Ross, MD, University of Virginia Health Science Center, Charlottesville, VA. Dr. Ross’s research project is entitled, "Living Related Pulmonary Lobar Transplantation."

1998 ISHLT/Roche Laboratories Transplant Research Fellowship Grant Recipients:

Kelly SA Blair, MD, Vanderbilt University Medical Center, Nashville, TN. Dr. Blair’s research project is entitled, "CD40L in Primate Allograft Tolerance and Viral Immunity."

A.M. El Gamel, MD, Wythenshawe Hospital, Manchester, United Kingdom. Dr. El Gamel’s research project is entitled "Cytokine Genotype and Accelerated Coronary Disease Following Cardiac Transplantation."

1998 ISHLT/Fujisawa Transplant Research Fellowship Grant Recipient:

Alyssa M. Krasinskas, MD, University of Pennsylvania Medical Center, Philadelphia, PA. Dr. Krasinskas’s research project is entitled, "The Role of Bone Marrow-Derived Elements in Allograft Rejection."

1998 ISHLT/Novartis Transplant Research Fellowship Grant Recipient:

Margaret L. Schwarze, MD, MPP, Massachusetts General Hospital, Cambridge, MA. Dr. Schwarze’s research project is entitled, "The "Thymoheart" Allograft: Effects of Vascularized Donor Thymus on Chronic Rejection and Xenotransplantation."

1998 ISHLT/Wyeth-Ayerst Transplant Research Fellowship Grant Recipient:

Christine L. Lau, MD, Duke University Medical Center, Durham, NC. Dr. Lau’s research project is entitled, "The Role of Antibodies in Discordant Pulmonary Xenograft Rejection."

Heart Failure Council Initiates New Registry

The ISHLT Scientific Council on Heart Failure and Transplant Medicine has initiated a new registry entitled "The ISHLT-ANMCO Mitral Repair/Replacement in Chronic Left Ventricular Dysfunction Registry and Trial (MIRACLE Trial)." This will be a two-phase study to explore the management of significant mitral regurgitation in the setting of left ventricular dysfunction.

Secondary mitral regurgitation is frequently present in patients with severe left ventricular dysfunction and is associated with worse prognosis. Whether correction of valvular incompetence can improve outcome is uncertain. Recent reports of combined left ventricular reduction and mitral valve repair (Battista procedure) suggest clinical benefit, although the relative contributions to this improvement seen with this combined intervention is uncertain (1). Furthermore, preliminary observations suggest that isolated mitral valve repair may be beneficial in patients with severe heart failure and secondary mitral regurgitation (2). However, the frequency and severity of secondary mitral regurgitation in patients with severe heart failure is unknown, as is the international experience with mitral valve replacement or repair in this group of patients. Therefore, the ISHLT/ANMCO MIRACLE registry/trial was designed to evaluate the entity of secondary mitral valve regurgitation in patients with severe left ventricular dysfunction and to allow design of a prospective randomized surgical interventions trial.

References

  1. McCarthy PM, Starling RC, Wong J et al: Early results with partial left ventriculectomy. J Thorac Cardiovasc Surg 97;114:755-65
  2. Bach DS, Bolling SF: Improvements following correction of secondary mitral regurgitation in end-stage cardiomyopathy with mitral annuloplasty. Am J Cardiol 96; 78:966-69

Initially, the registry data base will be compiled by participating members of the ISHLT and ANMCO (Association of National Medical Cardiologists of Hospitals in Italy). We hope to learn the following from the registry:

  1. 1. the number of patients with moderately severe to severe mitral regurgitation (MR) and LV dysfunction
  2. 2. the current methods of management of these patients
  3. 3. information to help us develop, establish, and make efficient a database system for future studies

The study will be under the auspices of ANMCO/ISHLT in Europe and ISHLT/ANMCO in the United States. ANMCO will collect the data forms and compile the data, which will be jointly owned by ISHLT and ANMCO. ANMCO has pledged to guarantee the safety and confidentiality of the data.

The following system will be used to collect data initially: All interested centers and ISHLT members are encouraged to participate. The data forms are available to be printed from the ISHLT web site (http://www.ishlt.org). Alternatively, ISHLT will mail a copy of the forms to anyone who cannot access them on the Internet. When a patient presents to a participating transplant center with significant mitral regurgitation and left ventricular dysfunction, the participating center will fill out the forms and send them to the ANMCO.

Registry enrollment will be from April 1998 to December 1998 and will include patients with the following characteristics:

  1. LV ejection fraction < 40% by echocardiography or radionuclide ventriculography
  2. At least moderate mitral regurgitation in at least one echocardiographic view or by contract venticulography
  3. No evidence of primary mitral valvular disease.

The prospective clinical trial endpoints will be defined based on registry participation and results and will begin enrollment by January 1999.

Minutes of Pulmonary Council Meeting

The ISHLT Scientific Council on Pulmonary Transplantation met on Thursday, April 16, 1998 at 7:00 pm at the Sheraton Chicago Hotel, Chicago, IL. The meeting was called to order by Dr. Paul Corris, Chairman.

Dr. Janet Maurer presented information regarding the proposed uniform guidelines for referral of patients for lung transplantation. The proposed guidelines, copies of which were distributed during the meeting, have been approved by the ISHLT board. In January 1998, they were sent for external review and also were reviewed and approved by the American Thoracic Society Board. They also have been approved by the European Respiratory Society. Current efforts are underway to coordinate nearly joint publication of the guidelines in the American Journal of Respiratory and Critical Care Medicine, Transplantation, The Journal of Heart and Lung Transplantation and a medical newsletter distributed in New Zealand and Australia. This joint publication is targeted for Fall, 1998.

Dr. Hertz presented information relating to electronic communications among the council members. In particular, ideas regarding the Council web page, as well as development of an electronic bulletin board or a listserve were discussed. Also discussed was the fact that any development would have to be done in conjunction with the ISHLT Administration and Board and that appropriate security and confidentiality mechanisms will need to be put into place. Dr. Hertz agreed to pursue this matter with Amanda Rowe following conclusion of the annual ISHLT meeting. All Council members are asked to submit their email addresses to Dr. Hertz (hertz001@tc.umn.edu) or Dr. Corris (paul.corris@ncl.ac.uk).

Concern was raised that improved communication between the Pulmonary Council and the ISHLT Board is needed. Dr. Mark Barr commented that the Board is very eager to hear and facilitate initiatives brought forward by the Council. Future Board meetings held in conjunction with the ISHLT meeting will dedicate time to hearing reports from the Councils. This was intended for the 1998 meeting but not well communicated to the Council.

Discussion was held regarding the development of a registry of multi-center clinical studies in progress. There also was considerable discussion regarding the possibility of developing consensus guidelines for clinical care of lung transplant patients. As a first step, Dr. Paradis has agreed to revise (shorten) the questionnaire which was distributed last year and to redistribute it in order to develop information regarding current clinical practice patterns. Individuals interested in reviewing this questionnaire prior to general distribution should contact Dr. Corris or Dr. Paradis directly.

Dr. Keith McNeil raised the issue of the possible need to revise the BOS Classification Scheme. After discussion it was decided that a committee would be convened to accomplish this. The committee will include members of the original BOS development panel. Other individuals interested in participating should contact Dr. Corris or Dr. Hertz.

1999 Annual Meeting Abstract Deadline Set

The abstract forms for the ISHLT 19th Annual Meeting and Scientific Sessions will be mailed in early July. The deadline for receipt of abstracts in the ISHLT Headquarters Office is October 9, 1998. All abstracts must be submitted on an original abstract form. Photocopies and fax copies may not be used to submit an abstract.

A new abstract category is being introduced this year, entitled New/Alternative Therapies to Transplantation. We encourage you to submit an abstract for consideration in this category. The Society is eager to increase the annual meeting’s emphasis on "cutting edge" and experimental therapies. Please inform colleagues in your university and hospital who may not have submitted an abstract in the past about this new category. Topics which would be suitable for this category include the following:

  • Artificial lung technology
  • "Permanent" mechanical cardiac assistance
  • Lung volume reduction surgery
  • Left ventricular volume reduction surgery (Battista procedure)
  • Cardiomyoplasty
  • Transmyocardial laser revascularization
  • High risk mitral valve repair/replacement
  • High risk coronary revascularization
  • Gene therapy for lung disease
  • Myoblast/cellular transplantation
  • Program information, meeting registration forms, and housing forms will be mailed to all Society members and interested individuals at the end of December. The meeting will be held at the San Francisco Hilton and Towers in San Francisco, CA from April 21-24, 1999.
Announcements

  • The new 1997-1998 ISHLT Membership Directories are being mailed to all members in early July. When your copy arrives, please check your listing carefully and notify us immediately of any inaccuracies. In particular, check your credential (MD, PhD, RN, etc.) to make sure it is correct, as well as your specialty classification. Our goal this year is to clean up these areas of our database and fill in any missing information. If your listing in the directory has any information omitted, please provide the missing information to ISHLT as soon as possible so that we can assure that our database is correct, complete, and up to date. Also, you will find the latest, updated version of the society Bylaws in the rear of the Directory.
  • After 5 years of providing devoted service and generating impressive improvements to the Journal of Heart and Lung Transplantation, the JHLT Editor, Maria Rosa Costanzo, has elected not to seek renewal of her appointment. Thus, the Society will next month begin the process of searching for a new Editor of the JHLT. An official announcement for the position opening will be mailed to all members in July, and resumes will be due at the ISHLT Headquarters Office by September 15. The incoming Editor will be selected by the Board of Directors at their October meeting. Beginning on January 1, 1999, the incoming Editor will begin a year of preparation and will assume the position of Editor beginning January 1, 2000.
  • The Board of Directors is pleased to announce that Jeffrey D. Hosenpud, MD, has been appointed to a second 5-year term as Medical Director of the ISHLT International Heart and Lung Transplantation Registry. Dr. Hosenpud has made significant improvements to the Registry during the past 5 years, and the Board is enthusiastic about the continued growth and improvement of the Registry under Dr. Hosenpud’s leadership.
  • Mark Your Calendars for the 1st Annual ISHLT Fall Education Meeting. This year’s meeting, conducted under the auspices of the ISHLT Education Committee, will cover the topic, "Cardiac Allograft Vasculopathy: Insights into Pathogenesis, Prevention, and Treatment". This course is being chaired by Leslie W. Miller, MD, University of Minnesota, and Mary E. Russell, MD, Harvard School of Public Health. The dates of this year’s meeting are September 25-27, 1998. The meeting will begin on Friday at 1:00 pm and will conclude on Sunday at Noon. The meeting will take place at the Grand Hyatt Hotel in Washington, DC. Program and registration information will be mailed to all members in early July. If you do not receive a copy, please contact the ISHLT Headquarters Office to have one sent to you. Please join us for this inaugural event on a topic that is sure to draw a full house.
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