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AASLD / EASL Clinical Research Single Topic Conference Intensive Care of the Patient with Acute on Chronic Liver Failure
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AASLD / EASL Clinical Research Single Topic Conference Intensive Care of the Patient with Acute on Chronic Liver Failure 
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Dates: March 18-19, 2010

Location:  Emory Conference Center Hotel in Atlanta, Georgia

Registration is Now Open!

Course Directors: Vicente Arroyo, MD
                        Rajiv Jalan, MD
                        Guadalupe Garcia-Tsao, MD
                        Patrick S. Kamath, MD

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Description:
The main aim of this conference is to develop consensus on the recognition, and management of the patient with Acute on Chronic Liver Failure (ACLF) in the Intensive Care Unit (ICU)

ACLF is the commonly used term to describe the rapid decline in liver function in patients with cirrhosis, usually secondary to sepsis and precipitated by gastrointestinal bleeding, infections, drugs, alcoholic hepatitis, etc.  There is no consensus on optimal management of such patients in the Intensive Care Unit. The lack of a cost-effective approach to these patients adds to the economic burden. The pathophysiology of ACLF is not clear but is likely to involve multiple organ dysfunctions arising from a systemic inflammatory response syndrome (SIRS).  Systemic sepsis is likely to be the common event in the decline in liver function.  Therefore, this single topic conference will assemble multidisciplinary experts on liver failure and multiple organ dysfunction syndromes.  The events leading up to multiple-organ dysfunction in liver disease will be reviewed.  Optimal management of the patient with acute on chronic liver failure in the Intensive Care Unit will be discussed.  Prognostic factors for ACLF will be determined so that patients who are candidates for liver assist devices might be more appropriately selected.

Goals and Objectives:

  • Develop consensus on the definition of ACLF
  • Discuss optimal evaluations and management for the patient with ACLF in the ICU
  • Discuss role of liver assist devices in patients with ACLF
  • Develop an international database on ACLF

This program is supported by the AASLD Clinical Research Single Topic Conference Board Restricted Fund and co-sponsored by the European Association for the Study of the Liver.  Additional program support is provided by educational grants from Gambro and Ikaria.

This program is not a continuing medical education (CME) activity.

Thursday, March 18, 2010 Session  Presenter
7:00am Breakfast  
Session I: Overview of Acute on Chronic Liver Failure Chair: Vicente Arroyo, MD
8:00-8:05am Scope of the Meeting Vicente Arroyo, MD
8:05-8:25am  Acute on Chronic Liver Failure: A Definite Clinical Entity Rajiv Jalan, MD
8:25-8:45am Liver Dysfunction in Sepsis Arun Sanyal, MD
8:45-9:05am Economic Burden of Acute on Chronic Liver Failure W. Ray Kim, MD
9:05-9:40am Overview of Multiple system Organ Failure and Systemic 
Inflammatory Response Syndrome		 Jean Louis Vincent, MD
9:40-10:00am Break
Session II:  Early Recognition of Acute on Chronic Liver Failure:   Precipitating Events and Prognostic Factors Chair: Rajiv Jalan, MD
10:00-10:20am Infection Guadalupe Garcia-Tsao, MD
10:20-10:40am Gastrointestinal Bleeding Roberto DeFranchis, MD
10:40-11:00am Alcoholic Hepatitis Vijay H. Shah, MD
11:00-11:20am Acute Viral Hepatitis Robert Fontana, MD
11:20-11:40am   Drug Induced Hepatitis Naga Chalasani, MD
11:40am-12:00pm Vascular Disease: Thrombosis and Ischemic Dominique Valla, MD
12:00-12:30pm Discussion
12:30 -2:00pm Lunch
Session III: Acute on Chronic Liver Failure: Management of the Patient in the ICU
2:00 -2:20pm Renal and Adrenal Abnormalities, Renal Replacement Therapy Pere Ginès, MD
2:20-2:40pm Pulmonary Abnormalities and Ventilatory Support Ram Subramaniam, MD
2:40-3:00pm Cardiovascular Abnormalities Samual Lee, MD
3:00-3:20pm Cerebrovascular Abnormalities Juan Cordoba, MD
3:20-3:40pm Coagulation Abnormalities and their correction Andrew Burroughs, MD
3:40-4:00pm   Nutritional Support Srinivasan Dasarathy, MD
4:00-4:30pm Break
Session IV: Acute on Chronic Liver Failure: Management of the Patient in the ICU

Chair: Guadalupe Garcia-Tsao, MD

4:30-5:00pm Surviving Sepsis Sergio Zanotti, MD
5:00-5:30pm Monitoring and hemodynamic support Julia Wendon
5:30-5:50pm Artificial/Bio-artificial Liver Support Scott Nyberg, MD
5:50-6:10pm Prognosis and indications for Liver Transplantation Patrick S. Kamath, MD
6:10-6:30pm Discussion
7:00pm Dinner

 Friday, March 19, 2010  Session Presenter
8:00-9:30am Breakout Sessions: Consensus Study Groups

Defining Acute on Chronic Liver Failure

 Chair: Patrick S. Kamath, MD
Optimal Therapy of ACLF

Chair: Julia Wendon, MbChB

Liver Assist Devices Chair: Rajiv Jalan, MD

Trials in Acute on Chronic Liver Failure

 Chair: Vicente Arroyo, MD
9:30-10:00am  Finalization of consensus reports by Chairs  
10:00-10:30am Coffee Break  
  Session V: Concluding Session: Presentation of Consensus Statements and Discussion Chairs: Vicente Arroyo, MD and Patrick S. Kamath, MD
10:30-10:45am Acute on Chronic Liver Failure: Definition and Prognostic Factors Patrick S. Kamath, MD
10:45-11:00am Optimal Therapy of ACLF Julia Wendon, MbChB
11:00-11:15am Liver Assist Devices Rajiv Jalan, MD
11:15-11:30am Trials in Acute on Chronic Liver Failure Vicente Arroyo, MD
11:30am  Concluding Remarks Vicente Arroyo, MD and Patrick S. Kamath, MD