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In this issue, we have in the spotlight, Maryanne Chrisant's, Pain and Suffering: The Catholic Perspective as we begin explore how our patients cope with pain and suffering. Jumping into the Editor's Corner with yours truly shifts us away from the Science of it all in the best interest of our patients to that other half of the duality of medicine for humanity's sake; the art of it. Over the year, it is hope that we attain a better grasp on how a patient lives as we continue to pursue the truth on why a patient dies. Next, we continue the annual meeting recapitulations with Edward Horn's ISHLT 2016 Pharmacy and Pharmacology Council Review: PHARMing for Answers, Walter Uber's Pharmacy & Pharmacology Council: With Great Power Comes Great Responsibility and Kyle Dawson's After ISHLT 2016: A few random thoughts.... This is followed by A Transplant Fellow's Experience at the 2016 International Heart & Lung Transplantation Annual Meeting by Liran Levy, Continued Enthusiasm of the MCS: Musings from the 2016 Annual ISHLT Meeting by Evgenij Potapov, Basic Science and Immunology at the ISHLT 2016 Annual Meeting by Javier Carbone, and aa Recap with from the ISHLT 2016: Ambulatory ECMO in Adults - We Like to Move It, Move It by Keith Wille. Under ISHLT News and Announcements, David Baran's lights up The Explosion of Social Media: The ISHLT and JHLT Catch on Social Fire!

Vincent Valentine, MD
Links Editor-in-Chief


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Pain and Suffering: The Catholic Perspective

Maryanne Chrisant, MD

My friend, Vincent, has asked me to expound a bit on Pain and Suffering. While having witnessed much pain and suffering, as a pediatric transplant and heart failure physician, my life has been blessed with little, or perhaps this is only my perception. How my perception has come to be shaped is a matter of perspective, and I can write freely from my perspective. But I'd like to explore further and invite you to explore with me. For the next few months I hope to change the position of my gnomon, and recast the viewpoint of pain and suffering from other religious and a-religious perspectives. Irrespective of the viewpoint, we can likely agree on a definition: pain is an objective experience; suffering describes an element of human reaction. Read more →


ISHLT 2016 Pharmacy and Pharmacology Council Review: PHARMing for Answers?

Edward Horn, PharmD, BCPS

links imageThis year's ISHLT Annual Meeting provided a tremendous amount of education content, not only for pharmacists, but for all individuals involved in advancing the care of our patient populations. Among the many sessions, I would like to focus on two presymposium Wednesday sessions - Anticoagulation in MCS: Can We Do Better? and Lifecycle Journey of the Hepatitis C Heart Failure Patient. Both of these sessions featured a multidisciplinary approach to managing these complicated patient populations. In the MCS session, the entire spectrum from thrombosis to bleeding in MCS was covered by Dr. Ulrich Jorde. Dr. Doug Jennings then discussed issues surrounding inherited thrombophilia in MCS patients and the potential impact on the use of antithrombotic therapy. Dr. Anna Meyer presented challenges in monitoring INRs and options of improving monitoring modalities with respect to vitamin K antagonists. Read more →

Pharmacy & Pharmacology Council: With Great Power Comes Great Responsibility

Walter E. Uber, PharmD

links imageIt is amazing to me to think about how far we have come as a council since "7 people met in a room" in San Diego 5 years ago to discuss the formation of a Pharmacy and Pharmacology Council within ISHLT. It is certainly ironic to me as we begin planning once again for our next meeting in San Diego on how we have evolved and how I hope we will continue to move forward "as a collective" with our contributions to the intellectual content and practice ideas and help the Society advance the care of this very complex patient population. Read more →

After ISHLT 2016: A few random thoughts...

Kyle Dawson, PharmD, MBA, BCPS

links imageFirst, I'd like to personally thank Andy Fisher [who, by the way, seems to be a genuinely cool guy] and all those responsible for planning and executing ISHLT's 2016 annual meeting. I can hardly imagine how much time and effort was spent making it happen. I look forward to this meeting each year for the opportunity to learn from the research generated by other institutions, listen to the experts debate today's current clinical controversies, and catch-up with colleagues from other parts of the country/world-this year's meeting did not disappoint.
A few random thoughts... My favorite talk of the meeting was probably Dr. Laurie Snyder's discussion of the immune response to CMV in transplant recipients and the idea that the duration of prophylaxis against CMV could be personalized by analyzing T-cells to identify patients less likely to develop CMV disease post-prophylaxis. Read more →

A Transplant Fellow's Experience at the 2016 International Heart & Lung Transplantation Annual Meeting

Liran Levy

links imageI was fortunate to attend the 2016 International Heart & Lung Transplantation (ISHLT) annual meeting in Washington, DC on April 26-30. The ISHLT is a multidisciplinary, professional organization dedicated to improving the care of patients with advanced heart or lung disease through transplantation, mechanical support and innovative therapies via research, education and advocacy. It was established in 1981 at a small gathering of cardiologists and cardiac surgeons. Today it consists of 3000 members from over 45 countries, representing over 15 different professional disciplines. ISHLT was my very first transplant conference of such magnitude. I did not know what to expect and nothing could have prepared me for what I witnessed. Many of my esteemed colleagues were attending as well and I was honored to be a part of the group representing Toronto Lung Transplant Program. Read more →

Continued Enthusiasm of the MCS: Musings from the 2016 Annual ISHLT Meeting

Evgenij Potapov, MD, PhD

links imageAs usual, the success of MCS is multifactorial. First, the combination of Core Competencies in Mechanical Circulatory Support before and Master Classes after the official meeting led to the sustained presence of many participants. Even the last MCS session of the meeting in the final hours of the last day was jam-packed and could not be closed on time because of very fruitful and lively discussions. This point also contribute to the overall success. All MCS sessions, including the pre-meeting symposia, sunrise symposia and abstract presentations were fine-tuned to one important topic which led to sometimes very deep, sometimes emotional, but always scientific discussions. Read more →

Basic Science and Immunology at the ISHLT 2016 Annual Meeting

Javier Carbone, MD, PhD

links imageThe International Society for Heart and Lung Transplantation meeting is held annually to provide a forum for the most recent advances in the field of heart and lung transplantation. There continues to be a strong basic research component. Research on humoral and cellular factors that influence the interplay between the allograft and the host immune cells, and immunological factors that antagonize infectious complications, had great presence at the conference. In the pre-meeting symposium 12, new information about polyfunctional immune responses was presented. Borrowing information from other viral diseases, effective vaccination is associated with a polyfunctional response; HIV elite controllers have a polyfunctional response; control of hepatitis C, tuberculosis and other infections have been linked to a polyfunctional response. Read more →

Recap from ISHLT 2016: Ambulatory ECMO in Adults - We Like to Move It, Move It

Keith M. Wille, MD, MSPH

links imageWorldwide, the use of extracorporeal life support has exploded onto the seen in recent years, with more centers now offering extracorporeal membrane oxygenation (ECMO) to select patients with advanced heart and/ or lung failure. ECMO may be performed as a bridge to transplantation or destination therapy, as a bridge to deciding on transplant candidacy, as a bridge to recovery of organ function, or as a means of support for post-transplant complications, such as primary graft dysfunction. The increase in ECMO use is likely related to several newer developments, such as improved technology, device performance, and safety; advances in patient management; and improvements in overall patient outcomes. Read more →


The Explosion of Social Media: The ISHLT and JHLT Catch on Social Fire!

David A Baran, MD, FACC, FSCAI

links imageSince the advent of the World Wide Web at the beginning of the 1990's, the pace of innovation has increased exponentially. The advent of social media services such as Facebook, Twitter and LinkedIn have contributed to a global sense of "connectedness" at some level and have functioned as avenues to disseminate information. While some of these services started as ways for teenagers to chat, they have become legitimate tools for adults to exchange information of a professional nature and have an immediacy which has challenged "old school" media such as traditional journals and newspapers. In the area of science, we have a plethora of journals which compete to publish the material of highest interest and increasingly, the "consumption" of this information is in electronic format. Read more →


The Art of It: For Humanity's Sake

Vincent Valentine, MD

links imageAre we training a generation of medical students or other healthcare providers who cannot take histories? Over the last several years, a technological explosion of skillful access to electronic information, computerized studies, sophisticated devices and a wide array of biomarkers demanding our attention and analysis to make critical decisions about patient's lives have captivated our attention. The values of blood tests, lab results and interpretations of various procedures along with the electronic medical record have diverted our attention away from the patient. The older model of tending to what a patient says or tells us at the bedside or in the clinic is becoming antiquated. Read more →


Vincent G Valentine, MD

Editorial Staff

"Man cannot remake himself without suffering, for he is the marble and the sculptor"
— Alexis Carrel

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Disclaimer: Any opinion, conclusion or recommendation published by the Links is the sole expression of the writer(s) and does not necessarily reflect the views of the ISHLT.