Postgraduate Course

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Keeping the Patient With End-stage Cirrhosis Alive
Friday, October 30   4:00 – 8:00 pm
Saturday, October 31   8:00 am – 5:00 pm
Course Directors:
Arun J. Sanyal, MD    Kris Kowdley, MD     Hugo E. Vargas, MD

Coming Soon: This programming will be available for online viewing as part of the Best of the Liver Meeting in April 2010

Cirrhosis is a leading cause of death in the general population, and liver transplantation is the only approach that reliably improves both the duration of life and the quality of life in patients with cirrhosis and end-stage liver disease. But not everyone is a candidate for liver transplantation, and the outcomes after liver transplantation are critically dependent on the patient's clinical condition at the time of transplantation, making optimal management of the patient prior to transplantation critical.

This course will provide an overview of key management issues in the care of patients with cirrhosis and will cover:

How to assess prognosis and determine the need to refer for transplantation, evaluation of the transplant recipient, and donors for living related transplantation.
Evaluation and management of portal hypertension and its complications such as variceal hemorrhage, ascites, and encephalopathy.
Management of variceal hemorrhage.
Evaluation and management of acute on chronic liver failure.
Issues related to coagulopathy in cirrhosis and the use of blood products--an emerging important clinical issue where several traditional paradigms have recently been challenged.
Ascites, encephalopathy, and cardio-pulmonary disorders in patients with cirrhosis.
Hepatocellular cancer, treatment of underlying medical disorders, and miscellaneous topics such as the use of drugs, management of malnutrition, prevention of infections (other than spontaneous bacterial peritonitis), and end-of-life care-related issues.
Individualizing the management strategy for hepatocellular cancer.

Goals and Objectives:

Describe a multi-disciplinary approach to the management of patients with end-stage cirrhosis.
Discuss the complications of cirrhosis and the approach taken for prevention, early detection, and management of such complications.
Identify methods used to preserve hepatic synthetic function in subjects with cirrhosis.
Identify common “non-hepatic” clinical problems that affect outcomes in patients with cirrhosis and the candidacy of patients for liver transplantation and the management of such conditions.
Explain how to integrate clinical management decisions in subjects with cirrhosis with their ability to receive a liver transplant.

Program
Friday, October 30
4:00-4:10pm	Welcome Remarks
Session I: Liver Transplantation: Who, When and How		Moderators Kris V. Kowdley, MD and Sandy Feng, MD, PhD
4:10-4:30pm	When to Consider Liver Transplantation: Assessment of Prognosis in Subjects With Cirrhosis	Patrick S. Kamath, MD
4:30-4:50pm	Evaluation of the Transplant Recipient	Adrian Reuben, MBBS, FRCP, FACG
4:50-5:10pm	Evaluation of a Potential Donor for Live Donor Liver Transplantation	Richard T. Stravitz, MD
Session II: Evaluation and Management of Gastro-esophageal Varices		Moderators: Vijay Shah, MD and Naga P. Chalasani, MD
5:15-5:35pm	The Pathopshysiology of Portal Hypertension and Development of Varices	Don C. Rockey, MD
5:35-5:55pm	Management of Active Variceal Hemorrhage	Jaime Bosch, MD, PhD
5:55-6:15pm	Gastric Varices and Portal Gastropathy	Shiv Kumar Sarin
6:15-6:40pm	Debate: Endoscopic Therapy Is the Preferred Approach for Primary Prevention of Variceal Hemorrhage	For: Loren A. Laine, MD Against: A.K. Borroughs, FRCP
6:40-7:00pm	Break
Session III: Management of End-stage Liver Disease in the Pediatric Population		Moderators: Sue V. McDiarmid, MD and Jorge A. Bezerra, MD
7:00-7:20pm	Causes and Management of Portal Hypertension in Children	Benjamin L. Schneider, MD
7:20-7:40pm	Biliary Atresia and Its Management	Saul J. Karpen, MD, PhD
7:40-8:00pm	Timing and Evaluation of Liver Transplant in Children	John C. Bucuvalas, MD
Saturday, October 31
Session IV: Ascites		Moderators: Pierre Gines, MD and Bruce A. Runyon, MD
8:00-8:20am	The Hepatorenal Axis: The Pathophysiology of Ascites and Renal Failure in Cirrhosis	Florence Wong, MD
8:20-8:40am	Difficult to Manage Ascites: Causes, Evaluation and Management	Thomas D. Boyer, MD
8:40-9:00am	Prevention and Management of Renal Failure in the Subject with Cirrhosis and Ascites	Guadalupe Garcia-Tsao, MD
Session V: Encephalopathy		Moderators: Kevin D. Mullen, MD and Mary E. Rinella, MD
9:00-9:20am	Current Concepts on the Pathogenesis of Neurologic Dysfunction in Cirrhosis	Roger F. Butterworth, MD
9:20-9:40am	Subclinical and Chronic Encephalopathy: Practical Issues in Evaluation and Management	Jasmohan Bajaj, MD
9:40-10:00am	Acute on Chronic Liver Failure	Rajiv Jalan, MD
10:00-10:30am	Break
Session VI: Extrahepatic Complications of Cirrhosis		Moderators: Paul Kwo, MD and Anne M. Larson, MD
10:30-10:50am	Hepato-pulmonary Syndrome	Michael B. Fallon, MD
10:50-11:10am	Cirrhotic Cardiomyopathy	Samuel S. Lee, MD
11:10-11:30am	Portopulmonary Hypertension	Karen Swanson, DO
11:30-11:50am	Bone Disease in Patients with Cirrhosis	J. Eileen Hay, MD
11:50am-1:30pm	Lunch
Session VII: Hepatocellular Carcinoma		Moderators: K. Rajender Reddy, MD and Josep Llovet, MD
1:30-1:50pm	Mechanisms of Carcinogenesis and Identification of Novel Therapeutic Targets	Gregory J. Gores, MD
1:50-2:10pm	Screening and Initial Management for HCC	Jorge A. Marrero, MD
2:10-2:30pm	Matching Locoregional Therapy and Disease Severity	Laura M. Kulik, MD
Session VIII: Disease Specific Management		Moderator: Norah Terrault, MD
2:30-2:50pm	Viral Hepatitis	Gregory T. Everson, MD
2:50-3:10pm	Alcohol/Drug Abuse and Other Behavioral Disorders	Michael R. Lucey, MD
3:10-3:30pm	Drugs and Hepatotoxicity	William M. Lee, MD
3:30-3:45pm	Break
Session IX: Management Quandaries in End-Stage Liver Disease		Moderators: Sammy Saab, MD and Hugo E. Vargas, MD
3:45-4:05pm	Nutrition Related Issues in Subjects with Cirrhosis	Arthur J. McCullough, MD
4:05-4:25pm	Coagulation Disorders and the Use of Blood Products in Cirrhosis	Stephen H. Caldwell, MD
4:25-4:45pm	Non-hepatic Surgery in the Subject with Cirrhosis: Evaluation of Risk and Management Strategies	Kim M. Olthoff, MD
4:45-5:00pm	Wrap-up	Arun J. Sanyal, MD

Registration Rates	Advance	Regular
Member	$425	$525
Corporate Affiliate Member	$425	$525
Trainee Member	$170	$270
Hepatology Associate Member	$170	$270
Non-Member	$620	$720
Trainee Non-Member	$240	$340
Hepatology Associate Non-Member	$240	$340

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Postgraduate Course

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