Primary Audience: HF/HTX
Secondary Audience: MCS

Session Summary: Hypertrophic and infiltrative cardiomyopathies are often underrecognized. There has been increasing understanding of HCM and cardiac amyloidosis with rapid development of diagnostic modalities and treatment strategies. This symposium will begin with a case and then review recent advances, highlighting key therapeutics that are available and being developed. The role of heart transplant and advanced therapies in these entities will be outlined.

Chairs: Jignesh K. Patel, MD, PhD and Marta Farrero Torres, MD
 

7:00 AM	CASE PRESENTATION of HCM: Gasping and Dizzy - Please Help! Imad Hussain, MD, Houston Methodist Hosp, Houston, TX, USA
7:05 AM	Veni, Vidi, Vici: Pathophysiology and Therapeutic Options in Hypertrophic Cardiomyopathy Eulalia Roig, MD, Hospital Sant Pau, Barcelona, Spain
7:25 AM	CASE PRESENTATION of Cardiac Amyloidosis: I Can't Breathe and My Tongue is Too Big! Song Li, MD, University of Washington, Seattle, WA, USA
7:30 AM	Double Double Toil and Trouble: Physiology and Therapeutic Options for Cardiac Amyloidosis Margot Davis, MD, University of British Columbia, Vancouver, BC, Canada
7:50 AM	10-min Panel Discussion

Primary Audience: LF/LTX
Secondary Audience: BSTR, PHARM

Session Summary: As the number of older transplant patients continues to grow it becomes more important to understand age-associated immune changes, which may influence the impact of immunosuppression. Older lung transplant patients experience increased rates of infection, malignancy, and death, but decreased rates of rejection, suggesting over immune suppression. Yet at the same time, older transplant recipients experience increased levels of inflammation.

Chairs: Jonathan P. Singer, MD, MS and Hanneke Kwakkel-van Erp, MD, PhD
 

7:00 AM	Frailty and Pro-Inflammatory Cytokines: Potential Biomarkers for Poor Outcomes? Joshua Diamond, MD, University of Pennsylvania, Philadelphia, PA, USA
7:15 AM	Q&A
7:20 AM	Immune Senescence and Transplantation: Balance Between Infection and Rejection Joanna M. Schaenman, MD, PhD, UCLA School of Medicine, Los Angeles, CA, USA
7:35 AM	Q&A
7:40 AM	Challenges in Medication Administration in Older Transplant Patients Patricia Ging, PharmD, Mater Misericordiae University Hospital, Dublin, Ireland
7:55 AM	Q&A

Primary Audience: MCS
Secondary Audience: HF/HTX

Session Summary: The aim of this symposium is to update attendees on cutting edge techniques and experiences in the realm of ECMO, related both to BTT and non-BTT populations. Therapies and strategies that used to seem very isolated (mobilizing on ECMO, etc.) are likely more mainstream than previously thought. An understanding of the data and outcomes may lead to expanded international adoption of some useful practices.

Chairs: Feras Khaliel, MD, PhD and Ivan Knezevic, MD
 

7:00 AM	Pressure Volume Loops: What Insight Can They Give Us on Device Strategy? Navin K. Kapur, MD, Tufts Medical Center, Boston, MA, USA
7:15 AM	Q&A
7:20 AM	The Future of ECMO: It’s All About Hemocompatibility Omar Saeed, MD, Montefiore Medical Center, Bronx, NY, USA
7:35 AM	Q&A
7:40 AM	When the Bridge Has Termites: The Impact of ECMO-Related Infections on Post-Transplant Outcomes in Bridged Patients Priya Nair, MD, St Vincent's Hospital, Sydney, Australia
7:55 AM	Q&A

Primary Audience: PATH
Secondary Audiences: BSTR, LF/LTX, PEDS

Session Summary: Clinical and pathologic definitions for chronic rejection in lung transplantation - antibody-mediated rejection (AMR) and chronic lung allograft dysfunction (CLAD) - have undergone rapid changes over the past decade. This session will provide an update on the two major areas of discussion and acquisition over the recent years (AMR, CLAD) and potential areas for future development.

Chairs: Monique Malouf, MD and Desley Neil, FRCPath
 

7:00 AM	Clinical Review of Antibody Mediated Rejection and Chronic Lung Allograft Dysfunction Navin K. Kapur, MD, Tufts Medical Center, Boston, MA, USA
7:15 AM	Pathology of Antibody Mediated Rejection Fiorella Calabrese, MD, University of Padua, Padua, Italy
7:30 AM	Pathology of Chronic Lung Allograft Dysfunction David M. Hwang, MD, PhD, Toronto General Hospital, Toronto, ON, Canada
7:45 AM	15-min Panel Discussion

Primary Audience: PH
Secondary Audience: CTEPH

Session Summary: Exercise testing plays a key role in the management of PAH and CTEPH, diseases with exercise-induced symptoms. In contrast with 6MWD, CPET provides unique insights in the pathophysiology of PAH and CTEPH. In addition, the role of key variables derived from CPET on outcome may be useful in assessing treatment efficacy in clinical practice and maybe clinical trials. This symposium will review the various aspects of this technique, from pathophysiology to outcome prediction.

Chairs: Marco Guazzi, MD and Dana P. McGlothlin, MD
 

7:00 AM	Bicycle Race: Basic Principles of CPET Lisa Mielniczuk, MD, University of Ottawa Heart Institute, Ottawa, ON, Canada
7:15 AM	Under Pressure: CPET in PAH and CTEPH Ron Oudiz, MD, UCLA Medical Center, Los Angeles, CA, USA
7:30 AM	Don’t Stop Me Now: CPET to Predict Outcome in PAH - Time for a Change! Jean-Luc Vachiery, MD, Erasme University Hospital, Brussels, Belgium
7:45 AM	15-min Panel Discussion

Primary Audience: PHARM
Secondary Audiences: HF/HTX, LF/LTX, NHSAH

Session Summary: The purpose of this symposium is to review substances of abuse pre- and post-transplant. The symposium will focus on use of medications for pain and anxiety, smoking (nicotine and marijuana), and alcohol use. Speakers will present available evidence describing why these substances are harmful when used before and after transplant and offer guidance for cessation or therapeutic alternatives.

Chairs: Martin Zamora, MD and Vincent G. Valentine, MD
 

7:00 AM	‘Hurts So Good’: Analgesia Beyond Opioids Amanda Ingemi, PharmD, Sentara Norfolk General Hospital, Norfolk, VA, USA
7:15 AM	Q&A
7:20 AM	So, Light 'em if You've Got 'em - or Don't! Smoking Pre- and Post-Transplant Erik Verschuuren, MD, PhD, University Medical Centre Groningen, Groningen, Netherlands
7:35 AM	Q&A
7:40 AM	How Much is Too Much? Alcohol Use and Cessation Pre- and Post-Transplant Mary Amanda Dew, PhD, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
7:55 AM	Q&A

Primary Audience: ID
Secondary Audiences: LF/LTX, PATH

Session Summary: This symposium will review the evidence and discuss the utility of detection of pathogens from surveillance bronchoscopies after lung transplantation. Evidence will be presented regarding the interpretation and treatment of positive culture results from surveillance bronchoscopy. We will review and analyze the management/treatment of bacteria, fungi, atypical mycobacteria and CMV in asymptomatic patients.

Chairs: Are Holm, MD and Stephanie M. Pouch, MD
 

8:00 AM	‘Critter Country’: Treatment and Eradication of Bacteria and Bacterial Biome Nicolas Mueller, MD, University Hospital Zurich, Zurich, Switzerland
8:15 AM	Q&A
8:20 AM	‘Fungal Frontierland’: Pathogens or Colonizers? Me-Linh Luong, MD, St. Luc Hospital, Montréal, QC, Canada
8:35 AM	Q&A
8:40 AM	‘Off Main Street’: Atypical Mycobacteria - What, When and How to Manage Fernanda Silveira, MD, University of Pittsburgh, Pittsburgh, PA, USA
8:55 AM	Q&A
9:00 AM	‘CMV Square’: Lung Transplant Recipients with CMV Positivity in a Bronchoscopy without CMV DNAemia Jutta K. Preiksaitis, MD, University of Alberta, Edmonton, AB, Canada
9:15 AM	Q&A
9:20 AM	‘Tomorrowland’: A Case-Based Approach to Managing Bronchoscopy Results Shalika B. Katugaha, MD, Inova Fairfax Hospital, Annandale, VA, USA
9:40 AM	Q&A

Primary Audience: MCS

Session Summary: This symposium will examine state of the art knowledge on device programming and medical management of LVAD patients. Current controversies such as the utility of platelet function monitoring and invasive hemodynamic testing will be reviewed and debated.

Chairs: Marco Masetti, MD, PhD, and Garrick C. Stewart, MD
 

8:00 AM	What are We Treating with Heart Failure Therapy after MCS: the LV, the RV, the Periphery or Ourselves? Maria Frigerio, MD, A.O. Niguarda Ca ' Granda, Milan, Italy
8:20 AM	Antiplatelet Therapy: Fixed Dose or Functional Assays? Jeffrey J. Teuteberg, MD, Stanford University School of Medicine, Stanford, CA, USA
8:35 AM	Time in Therapeutic Range: Is There an Optimal Way to Manage INR? Douglas L. Jennings, PharmD, New York-Presbyterian Hospital, New York, NY, USA
8:50 AM	Pump Data: Do We Need It to Decide Changes in Therapy? Francesco Moscato, PhD, Medical University of Vienna, Vienna, Austria
9:05 AM	DEBATE: You Need Information from Invasive Hemodynamics to Properly Manage an LVAD (PRO) Nir Uriel, MD, University of Chicago, Chicago, IL, USA
9:20 AM	DEBATE: You Need Information from Invasive Hemodynamics to Properly Manage an LVAD (CON) Emma Birks, MD, PhD, University of Louisville, Louisville, KY, USA
9:35 PM	10-min Panel Discussion

Primary Audience: LF/LTX
Secondary Audience: MCS

Session Summary: This symposium will bring experts in Ex-Vivo Lung Perfusion and donor lung management from all over the world. Current practices, different models, ongoing clinical trials with EVLP and added therapeutics will be discussed. The attendee will increase his or her understanding of the technique, its applications and future directions.

Chairs: John Dark, MB, FRCS and Tiago Machuca, MD, PhD
 

10:15 AM	Implementation of High Volume Clinical EVLP: The Toronto Model Shaf Keshavjee, MD, FRCSC, Toronto General Hospital, Toronto, ON, Canada
10:30 AM	Rationale for Portable EVLP Wiebke Sommer, MD, Hannover Medical School, Hannover, Germany
10:45 AM	Benefits and Barriers of a Do-It-Yourself EVLP Program Peter Hopkins, FRACP, The Prince Charles Hospital, Brisbane, Australia
11:00 AM	Organ Procurement Organization-based EVLP Program Duane Davis, MD, MBA, Florida Hospital, Orlando, FL, USA
11:15 AM	Experience with a Third-Party EVLP Program Kenneth R. McCurry, MD, FACS, Cleveland Clinic, Cleveland, OH, USA
11:30 AM	The Role of Biomarkers in EVLP Andrew J. Fisher, FRCP, PhD, Freeman Hospital, Newcastle Upon Tyne, UK
11:45 AM	15-min Panel Discussion

Primary Audience: PATH
Secondary Audiences: HF/HTX, LF/LTX

Session Summary: The postmortem examination ("autopsy") is underutilized in modern medicine, but provides critical information to the clinicians, families and loved ones of the decedent to help them understand the decedent's clinical course. Data obtained from autopsies may be used by hospital quality personnel, researchers, policy makers, registries and device manufacturers to improve the state of thoracic transplantation and mechanical circulatory support therapy.

Chairs: Lorriana E. Leard, MD and Carmela Tan, MD
 

10:15 AM	The Autopsy in the Modern Era: What the Clinician Still Would Like to Gain from an Autopsy Stephen C. Clark, MD, Freeman Hospital, Newcastle Upon Tyne, UK
10:30 AM	What the Pathologist Can Tell: More Than Just Cause of Death Anja C. Roden, MD, Mayo Clinic, Rochester, MN, USA
10:45 AM	How is a Postmortem Examination Performed: Frequently Asked Questions Billie S. Fyfe-Kirschner, MD, Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
11:00 AM	The Autopsy in the Mechanical Circulatory Support Patient Robert F. Padera, MD, PhD, Brigham & Women's Hospital, Boston, MA, USA
11:15 AM	The Autopsy in the Thoracic Transplant Patient Ornella Leone, MD, S. Orsola Hospital, Bologna, Italy
11:30 AM	The ‘Rapid Autopsy’: A Tool for Scientific Inquiry Dylan V. Miller, MD, Intermountain Central Lab, Murray, UT, USA
11:45 AM	15-min Panel Discussion

Primary Audience: PEDS
Secondary Audiences: HTX, MCS

Session Summary: Pediatric and congenital heart disease VAD support is a challenge because the population is heterogenous, VADs were not designed for complex anatomy and physiology, and compared with adults, the numbers, data and collective experience are extremely limited. Despite these challenges, pediatric centers have successfully adapted and utilized VADs to improve outcomes. This symposium will provide an opportunity for the pediatric community to share their experience with the broader MCS community.

Chairs: Angela Lorts, MD and Ulrich Jorde, MD
 

10:15 AM	Not Just Small Adults: Outcomes of Pediatric Patients with Continuous Flow Devices Christina J. VanderPluym, MD, Boston Children's Hospital, Boston, MA, USA
10:30 AM	Not Just Small Adults: Novel Antithrombosis Strategies Used in Pediatric VADs Oliver Miera, MD, Deutsches Herzzentrum Berlin, Berlin, Germany
10:45 AM	Not-So-Temporary Circulatory Support Aamir Jeewa, MD, Hospital for Sick Children, Toronto, ON, Canada
11:00 AM	Optimizing Hemodynamics of Continuous Flow VADS for Small Patients Lucas Eastaugh, MBBS, Royal Children's Hospital, Melbourne, Australia
11:15 AM	One Size Fits All? Strategies for Using Implantable VADs in Small Patients Antonio Amodeo, MD, Bambino Gesu Pediatric Hospital, Rome, Italy
11:30 AM	Building Bridges: Collaborative Learning to Improve Outcomes in VAD Care David M. Peng, MD, University of Michigan, Ann Arbor, MI, USA
11:45 AM	15-min Panel Discussion

Primary Audience: HF/HTX
Secondary Audiences: MCS, PEDS

Session Summary: The aim of this symposium is to describe the pathophysiology and management of heart failure syndromes that are unique to ACHD patients.

Chairs: Maryjane Farr, MD and David Crossland, MRCP
 

1:45 PM	Too Sick to Live, Too Well to Die: When Do You Transplant A Failing ACHD Patient? Daphne Hsu, MD, Children's Hospital Montefiore, Bronx, NY, USA
2:00 PM	Q&A
2:05 PM	Is Two Really Better Than One? Heart-Liver Transplantation in ACHD Clive J. Lewis, MB, BChir, PhD, FRCP, Papworth Hospital, Cambridge, United Kingdom
2:20PM	Q&A
2:25 PM	Under Pressure: Managing Pulmonary Hypertension in ACHD Robert Weintraub, MD, Royal Children's Hospital, Parkville, Australia
2:40PM	Q&A
2:45 PM	I've Got Options: VADs in Patients with ACHD David Morales, MD, Cincinnati Children's Hospital, Cincinnati, OH, USA
3:00 PM	Q&A
3:05 PM	The Failing Sub-Pulmonic RV in Congenital Heart Disease: Forgotten, But Not Gone Wendy M. Book, MD, Emory University, Atlanta, GA, USA
3:20 PM	Q&A

Primary Audience: HF/HTX
Secondary Audiences: ID, LF/LTX, MCS, PEDS, PH

Session Summary: This symposium will highlight the most exciting publications in JHLT over the past year, each paper followed by a discussion by one of the senior editorial consultants of the journal to relate the presented articles to the greater body of published literature and discuss how they advance our understanding in the field.

Chairs: Manreet Kanwar, MD and Martin Schweiger, PhD, MD
 

1:45 PM	JHLT Best Papers of 2018 Patricia A. Uber, PharmD, Virginia Commonwealth University, Richmond, VA, USA
1:50 PM	Highlights of Heart Transplantation and MCS Simon Pecha, MD, University Hospital Hamburg, Hamburg, Germany
2:05 PM	Invited Discussant in Heart Transplantation and MCS Francis D. Pagani, MD, PhD, University of Michigan, Ann Arbor, MI, USA
2:15 PM	Highlights of Lung Transplantation and Pulmonary Hypertension Peter Riddell, MBBS, Mater Misericordiae University Hospital, Dublin, Ireland
2:30 PM	Invited Discussant in Lung Transplantation and Pulmonary Hypertension Jason D. Christie, MD, University of Pennsylvania, Philadelphia, PA, USA
2:40 PM	Highlights of Pediatric Heart and Lung Transplantation Ann R. Punnoose, MD, Children's Hospital of Wisconsin, Milwaukee, WI, USA
2:55 PM	Invited Discussant in Pediatric Heart and Lung Transplantation Stuart C. Sweet, MD, PhD, St. Louis Children's Hospital, St. Louis, MO, USA
3:05 PM	Highlights of Infectious Disease Jonathan M. Hand, MD, Ochsner Medical Center, New Orleans, LA, USA
2:15 PM	Invited Discussant in Infectious Diseases Emily A. Blumberg, MD, University of Pennsylvania, Philadelphia, PA, USA

Primary Audience: PH
Secondary Audiences: CTEPH, PATH

Session Summary: This symposium, in collaboration with the Pulmonary Vascular Research Institute (PVRI), will focus on controversies and new proposed developments under review since the recent World Symposium on Pulmonary Hypertension, exploring the concept of changing the definition to mean pulmonary artery pressure of 20mmHg and the implications for future management of patients, risk stratification of patients with PAH and best approach, and which best clinical trial endpoint should be adopted.

Chairs: Colin Church, MD, PhD and Marc A. Simon, MD
 

1:45 PM	Feeling the Pressure: New Hemodynamic Classification of Pulmonary Vascular Disease Robert P. Frantz, MD, Mayo Clinic, Rochester, MN, USA
2:00 PM	Q&A
2:05 PM	The Drugs Don’t (or might not) Work Anymore! Implications for Treatments in PAH with the New Hemodynamic Definition Mardi Gomberg-Maitland, MD, Inova Fairfax Hospital, Falls Church, VA, USA
2:20 PM	Q&A
2:25 PM	Too Risky for PAH? Patient Stratification and Implications for Treatment Paul Hassoun, MD, Johns Hopkins University, Baltimore, MD USA
2:40 PM	Q&A
2:45 PM	DEBATE: Quality Over Quantity? Future Trial Primary Endpoints Should Be QOL Focused (PRO) Ioana R. Preston, MD, Tufts Medical Center, Boston, MA, USA
3:00 PM	DEBATE: Quality over Quantity? Future Trial Primary Endpoints Should be QOL Focused (CON) Ardeschir Ghofrani, MD, University of Giessen, Giessen, Germany
3:15 PM	Debate Rebuttal (PRO) - Ioana R. Preston, MD, Tufts Medical Center, Boston, MA, USA
3:20 PM	Debate Rebuttal (CON) - Ardeschir Ghofrani, MD, University of Giessen, Giessen, Germany

Primary Audience: ID
Secondary Audiences: LF/LTX, PATH, PHARM

Session Summary: Fungal infections after thoracic transplantation are associated with high mortality. Prophylaxis and treatment come with various complications including drug-drug interactions, toxicities, treatment failure and emerging resistance. This symposium will provide insights regarding the epidemiology, prevention, diagnosis and treatment approaches to take when faced with the challenges of fungal infections in thoracic transplantation.

Chairs: Orla Morrissey, MD and Gregory A. Fishbein, MD
 

4:00 PM	Defining Fungal Infection: Not a TRIVIAL PURSUIT Erika D. Lease, MD, University of Washington, Seattle, WA, USA
4:15 PM	DEBATE: Every Patient Should Receive Antifungal Prophylaxis After Lung Transplantation (PRO) John W. Baddley, MD, MSPH, University of Alabama at Birmingham, Birmingham, AL, USA
4:30 PM	DEBATE: Every Patient Should Receive Antifungal Prophylaxis After Lung Transplantation (CON) Shahid Husain, MD, MS, University Health Network, Toronto, ON, Canada
4:45 PM	Don’t Be SORRY! Tips and Tricks for Managing Azole Antifungal Agents Tara Veasey, PharmD, BCPS, Allegheny General Hospital, Pittsburgh, PA, USA
5:00 PM	Not a MONOPOLY: Antifungal Drug Administration Via the Inhaled Route Antonio B. Roman, MD, PhD, Hospital General Vall D'Hebron, Barcelona, Spain
5:15 PM	Are We in TROUBLE? Emergence of Azole-Resistant Molds Minh-Hong Nguyen, MD, University of Pittsburgh, Pittsburgh, PA, USA
5:30 PM	15-min Panel Discussion