A glimpse of the Congress Program
This is a session looking at preparing potential recipients from a cardiovascular standpoint in the most efficient and safe way to accomplish the most optimal perioperative and long term postoperative outcomes.
(1) Assess the role of Cardiac MRI in cirrhotic cardiac disease.
(2) Examine if non-contrast catheterization is a viable option for assessing CAD as part of a pre-LT workup.
(3) Discuss the anesthetic concerns of Fontan physiology prior to proceeding to the OR.
(4) Assess the ability of standard echocardiography to assess pediatric cirrhotic cardiomyopathy.
Immerse yourself in cutting-edge advancements during our symposium session on “ALF 2.0: Rethinking Management for a Promising Future.” Explore pioneering topics, including Immunotherapy, Extracellular Vesicles, AI integration, and Liver Repair Technologies, as experts share transformative insights to revolutionize Acute Liver Failure care. Join us for an inspiring and collaborative journey shaping the future of ALF management.
(1) Understand the latest advancements in immunotherapy and its application in the management of ALF
(2) Explore the role of extracellular vesicles in ALF and their potential as therapeutic agents
(3) Grasp the potential of Artificial Intelligence in ALF care
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The Model for End-Stage Liver Disease (MELD) score has revolutionized the liver allocation system by providing an objective measure to prioritize patients based on disease severity.
However, MELD score doesn’t give access to LT to some patients with complications associated with portal hypertension rather than liver insufficiency or with liver malignancy.
Allocation systems have adopted different strategies in order to overcome this problem with significant variations across the world.
This session aims to explore and compare the liver allocation systems and MELD exception point policies for HCC and other etiologies across different continents, shedding light on the rationale behind these variations and their impact on patient/social outcomes, focusing on deceased liver donor allocation.
The primary objective of this session is to provide an overview of the liver allocation systems in Asia, Europe, Latin America, and the United States, focusing on the variation in MELD exception points for HCC and other etiologies.
By understanding the regional differences, we aim to promote knowledge sharing and foster a global dialogue on optimizing liver allocation policies for improved access to LT Each speaker will:
– Present an overview of the liver allocation system in each region/country
– Discuss the criteria and guidelines for MELD exception points for HCC and other etiologies in each region/country
– Analyze the rationale behind the variations in liver allocation policies within each region/country – Highlight the impact of these policies on patient outcomes, impact to the LT society and organ utilization
In recent years, patients with a myriad of liver malignancies are being considered candidates for liver transplantation (hilar and intrahepatic cholangiocarcinoma, metastases of colorectal cancer, HCC beyond Milan criteria). Most of the studies focus on how to select candidates for liver transplantation but there is limited evidence on how to adapt our immunosuppression protocols to this setting. This may be of high relevance since the current immunosuppression protocols are based on calcineurin inhibitors, which are pro-oncogenic in a dose-dependent manner.
Liver failure is composed of acute/subacute liver failure and acute on chronic liver failure due to different etiologies and pre-existing liver conditions. These patients require extended care or liver transplantation to reduce mortality. Histopathology examination of the liver plays a significant role in early disease recognition, and proper patient management. In addition to that, there are many recent advances in liver transplant pathology, i.e. the New Banff Criteria, digital pathology (DP) and artificial intelligence (AI) application, as well as spatial transcriptome. These new developments will further improve clinical outcomes in liver transplant patients.
After this session, audience will understand more about histological features of liver failure and the New Banff Criteria for liver transplant as well as recent development in liver transplant pathology. The combination of both classical histopathology and recent advances in liver transplant pathology is the innovative aspect of this workshop.
(1) To understand histological patterns of liver failure as well as the New Banff Criteria for liver transplant.
(2) To compare the histological difference of liver failure between adults and pediatrics.
(3) To explore recent advances in digital pathology, artificial intelligence and spatial transcriptome in pathology and liver transplantation.
(1) Understand the risk factors, thrombus characteristics, clinical indications, and appropriate patient selection criteria for endovascular interventional management of both benign and malignant portal vein thrombus.
(2) Understand indications and treatment strategies for portal vein recanalization.
(3) Understand management of PVT before and after liver transplantation.
(4) Understand the indications and contraindications for endovascular management of malignant PVT by radioembolization and chemoembolization.
(5) Understand challenges, endovascular techniques to treat malignant PVT in a patient with HCC.
The participants of this session titled “Endovascular Management of Benign and Malignant Portal Vein Thrombosis” will learn how and when to treat PVT with appropriate interventional radiological methods in this group of patients.
The participants of this session will get to know the basic and advanced methods in the interventional radiological treatment of PVT in detail and will improve their ability to choose the appropriate method for the appropriate patient.
Endovascular management of both benign and malignant PVT are not easy and require individualized approach. Interventions like TIPS could be challenging in the setting of PVT. Recanalization procedures are important technique for making a potential recipient transplantable. Hepatocellular carcinoma is the most common type of primary liver cancer and in the advanced stages macrovascular invasion is one of the important complications that is closely related with poor prognosis, and portal vein tumor thrombus (PVTT) is the most frequent form. Locoregional intraarterial treatments, especially radioembolization, are important and becoming widely used option. They are effective therapies and could help to prolong survival and improve the quality of life and becoming an important downstaging and bridging option for PVTT cases.
Portal vein thrombosis (PVT) could be due to both benign and malignant causes.
Depending on the severity of liver disease, PVT could affect up to 26% of patients with cirrhosis and could lead to the development of detrimental outcomes such as variceal bleeding, ischemia, portal cholangiopathy and worsening of portal hypertension. For liver transplantation, it might affect the surgical outcome and survival of the recipient and is associated with higher posttransplant morbidity and mortality.
1) Evolution of Living Donor Liver Transplantation: What the Future Brings?
Dr. Mark Cattral, a seasoned Professor of Surgery at the University of Toronto, will share practical insights into the evolution of living-donor liver transplantation. Drawing on his extensive experience as the Surgical Director of the Living-Donor Liver Transplantation Program, Dr. Cattral’s talk promises an insightful glimpse into the future of this evolving field.
Dr. Jasmohan S. Bajaj, a distinguished Professor of Medicine and renowned researcher at Virginia Commonwealth University, will delve into the intersection of NASH, microbiome, and liver transplantation. As the Co-Editor-in-Chief of the American Journal of Gastroenterology and an expert in hepatology and nutrition, Dr. Bajaj’s extensive background ensures a comprehensive exploration of the microbiome’s role in transplant patients. Don’t miss the opportunity to gain insights from his vast experience in clinical trials and groundbreaking research.
Dr. John Roberts, Professor of Surgery at the University of California, San Francisco, brings his wealth of experience as a transplant surgeon forefront and opens new perspectives on the future of organ allocation, its challenges and opportunities as we step into the next millennium.
Provide a short description of main topics related to this session with especial emphasis inrelevance to the field and innovative aspects.
Viability testing is the key feature required to increase the safe use of livers with extended risk factors. A variety of biomarkers and thresholds were discussed in the literature often lacking validation and confirmation in larger real world clinical transplant series. This session will first provide an overview on the current practice with the three main organ perfusion techniques. Secondly, challenges identified with viability tests in clinical practice will be highlighted and discussed.
The Model for End-Stage Liver Disease (MELD) score has revolutionized the liver allocation system by providing an objective measure to prioritize patients based on disease severity. However, MELD score doesn’t give access to LT to some patients with complications associated with portal hypertension rather than liver insufficiency or with liver malignancy. Allocation systems have adopted different strategies in order to overcome this problem with significant variations across the world. This session aims to explore and compare the liver allocation systems and MELD exception point policies for HCC and other etiologies across different continents, shedding light on the rationale behind these variations and their impact on patient/social outcomes, focusing on deceased liver donor allocation. This journal issue tackles this in detail here.
The primary objective of this session is to provide an overview of the liver allocation systems in Asia, Europe, Latin America, and the United States, focusing on the variation in MELD exception points for HCC and other etiologies. By understanding the regional differences, we aim to promote knowledge sharing and foster a global dialogue on optimizing liver allocation policies for improved access to LT Each speaker will:
• Present an overview of the liver allocation system in each region/country
• Discuss the criteria and guidelines for MELD exception points for HCC and other etiologies in each region/country
• Analyze the rationale behind the variations in liver allocation policies within each region/country
• Highlight the impact of these policies on patient outcomes, impact to the LT society and organ utilization
(1) To discuss the current reality, overview and challenges of Liver transplantation in Latin America
(2) To learn about the differences in indications, prioritization and MELD exceptions throughout Latin American countries.
(3) To evaluate the regional efforts to maximize deceased donor and living donor liver transplantation
(4) To compare transplant registries and financial coverage for liver transplantation in different countries.
With tremendous advances in surgical and medical expertise, new technological innovations and ongoing improvements in critical care and anesthesia, multi-organ transplantation has become more standard across transplant centers. However, there is much to learn regarding optimal candidate selection, sequencing of placement of organs, post op ICU care as well as the ethical aspect of a recipient being offered more than one organ. This joint session of the AASLD/EASL/ILTS aims to address these questions as we evaluate the current landscape of multi-organ transplant and look to the future to improve optimal use of these scarce organs.
Objective #1: Understand the advancements and indications of dual or multi organ transplantation with a liver transplant
Objective #2: Understand the sequencing of organ placement, post op management and pitfalls to avoid
Objective #3: Evaluate the ethical challenges of multi-organ transplant in the context of scarcity of organs
