State of the Art Sessions

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Monday 25 September
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09:10-10:40             STATE OF THE ART 1 | ORGAN PRESERVATION AND ENHANCEMENTS

CREATORS: Gabriel Oniscu, Edinburgh, United Kingdom and Jacques Pirenne, Leuven, Belgium

2017: A growing need for transplantation and changing demographics that challenge any potential increase in organ transplantation. Clinical efforts and research focus on making more organs function better and creating more organs for the ever-growing demand. The race is on: will it be organ reconditioning or creating more organs off the shelf? This session will discuss some of the recent developments that may make organ shortage a thing of the past

  • Lectures :
  • Organ reconditioning should start in the donor.
  • Ex-situ organ reconditioning: living up to the promise?
  • Origami based tissue engineering
  • Choice cuts: growing organs in alternative environments

 

09:10-10:40             STATE OF THE ART 2 | MIX AND MATCH: THE RIGHT ORGAN FOR THE RIGHT RECIPIENT

CREATORS: Valentin Cuervas-Mons, Madrid, Spain and Eelco de Koning, Leiden, The Netherlands

The right organ for the right patient is a central theme in transplantation. To maintain good clinical transplantation outcome is an increasing challenge in light of both donors and recipients with more unfavourable characteristics that could negatively affect this outcome. In this session we will first focus on global aspects of donation and transplantation and subsequently zoom in on 3 categories of recipients that we commonly encounter in our transplantation clinics. Sergio Leone would name them: The immunized, The old and The diabetic            

  • Lectures :
  • World Overview on Transplantation Activities (A report of the Global Observatory on Donation & Transplantation).
  • The immunized patient.
  • The old patient.
  • The diabetic patient.

 

09:10-10:40             STATE OF THE ART 3 | THE BIOMARKER PERSPECTIVE: PRIME TIME OR PERPETUAL PROMISE?

CREATORS: Oriol Bestard, Barcelona, Spain and Maarten Naesens, Leuven, Belgium

Personalised medicine seems the new Holy Grail in medicine. But is it? And what has been achieved in transplantation?  In this session, we discuss the experiences of large consortia that search for biomarkers in the field of transplantation. Biomarkers for non-invasive diagnosis of rejection, for guidance on immunosuppression and for patient risk stratification. In addition, we learn that the efforts to discover and validate innovative biomarkers are huge and that the pipeline towards clinical implementation is long. Finally, we look into the mirror and the crystal ball,  evaluating the achievements made to date and the promises for the future.

  • Lectures :
  • BIOMARGIN - systems biology for non-invasive diagnosis of rejection.
  • BIO-DRIM - marker-assisted immunosuppression individualisation.
  • CTOT - biomarkers for transplant risk stratification.
  • The biomarker verdict: prime time or perpetual promise?

 

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Tuesday 26 September
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09:10 - 10:40           STATE OF THE ART 4 | NEW CONCEPTS IN TRANSPLANT INFECTIOUS DISEASES: MICROBIOTA, AND BEYOND

CREATORS: Marina Berenguer, Valencia, Spain and Nicolas Mueller, Zurich, Switzerland

Lectures :

  • Transkingdom interplay - the complex interactive world of the microbiome.
  • Knowledge and clinical applications of microbiota in transplantation.
  • Viruses and recipient immune response: relevant crosstalk in transplantation.
  • The impact of HCV treatment on liver transplantation.

 

09:10 - 10:40           STATE OF THE ART 5 | CELL THERAPY IN CLINICAL TRIALS

CREATORS: Marc Dahlke, Regensburg, Germany and Pietro Cippà, Zurich, Switzerland

Cell therapy offers great hope for being a suitable adjunct to conventional immunosuppression with all its downsights, however major issues emerged in the long translation process towards the clinic. How can technical and regulatory hurdles be overcome within a realistic time frame? Will cell therapy be commercially interesting and will its implementation relaunch solid organ transplantation? Experts share their experience and explain what we might expect from cell therapy for tomorrow and in 10 years.

Lectures :

  • Technical and regulatory issues. From the idea to the clinical application.
  • Sharing clinical experience. What can we learn from hematologists?
  • Translational studies. Why do we need cell therapy if we cannot avoid severe immunosuppression?
  • The future: Clinical applications of stem cells, transplantation vs. regeneration? Clinical applications of stem cells, transplantation vs. regeneration?

 

09:10 - 10:40           STATE OF THE ART 6 | ONE FOR ALL OR ALL FOR ONE; GETTING AWAY FROM PROTOCOLIZED MEDICINE

CREATORS: Georg Boehmig, Vienna, Austria and Nicolas Mueller, Zurich, Switzerland

The ultimate goal of transplantation is long-term survival with a well-functioning graft. Operationalization of post-transplant care with protocols based on evidence from clinical trials has had an important impact on the overall quality after transplantation. It is increasingly recognized though that the ‘one size fits all’ approach does not always optimally reflect the patient’s individual need. Hence, the concept of personalized medicine is on everyone's lips. This session aims to confront the reality by asking the following questions, focusing on four important topics in the field.

Lectures :

  • Personalized medicine now and in 10 years.
  • Individualized antimicrobial  prophylaxis.
  • Phenotypic diversity of rejection and allograft dyfunction.
  • Tailored immunosuppression.

 

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Wednesday 27 September
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09:10 - 10:40           STATE OF THE ART 7 | DONOR MANAGEMENT 

CREATORS: Arne Neyrinck, Leuven, Belgium and Jacques Pirenne, Leuven, Belgium

The pre-requisite for successful transplantation is the recruitment of organs of acceptable quality in order to limit the mortality on the waiting list and to guarantee optimal short- and long-term outcome. During the last years, we have experienced a renewed interest in strategies to optimize donor management, especially since liberalization of donor criteria has been introduced within the field.  In this session, we want to address the question if we can still extend the potential donor pool. Therefore the focus will be directed towards recent innovative approaches and towards potential risk factors that might limit further expansion.  The session wants to involve all professionals involved, including anaesthesiologists, intensivists, nurses, coordinators and transplant physicians.

Lectures :

  • How controlled is my DCD?
  • Should I perfuse my donor?
  • Tribulation in designing donor  intervention studies
  • How clean is my donor?

 

09:10 - 10:40           STATE OF THE ART 8 | PUSHING THE BOUNDARIES IN LIVING DONATION

CREATORS: Frank Dor, London, United Kingdom and Gabriel Oniscu, Edinburgh, United Kingdom

Live donation has become normal practice in many countries. The successful expansion of the acceptance criteria for live kidney donors is now challenged by emerging evidence for an increased relative risk for the development of renal failure on the long run. In this context it is even more important how transplant professionals provide tailor made information and risk assessments. How can we ensure that donors understand the potential risk? Do we have a good screening tool to assess potential psychological risk for live donors? Can we step away from standardized surgical approaches for live donor nephrectomy or is a tailor made approach more desirable? And one of the burning questions in liver transplantation currently is: Should living liver donor transplantation be advocated above deceased donor liver Tx, as is usually the case in kidney Tx ? This session focuses on the balance between Pushing the limits in the context of potential short and long-term complications.

Lectures :

  • To be or not to be a donor?  (How can we make sure potential donors understand the risks?).
  • Psychosocial evaluation of live donors - the need for a tool to determine psychological risk.
  • Tailor Made Live Donor Nephrectomy: a conversation between 2 surgeons.
  • Should live liver donor transplantation be advocated above deceased donor liver Tx?

 

09:10 - 10:40           STATE OF THE ART 9 | CELLULAR INTERACTIONS IN REJECTION

CREATORS: Lorna Marson, Edinburgh, United Kingdom and Olivier Thaunat, Lyon, France

Transplant rejection involves a coordinated attack of the graft by the innate and the adaptive immune systems of the recipient. Although direct visualization of this complex cellular interplay, made possible by recent technological progresses, has greatly improved our understanding of rejection pathophysiology, it has also led to unexpected observations. Indeed, like in other chronic inflammatory conditions, organized lymphoid tissue develops within allografts. This session will provide an update on cellular interactions in rejection and will discuss whether intragraft tertiary lymphoid organs contribute to graft rejection and/or tolerance.

Lectures :

  • Visualizing cell traficking underlying allosensitization by two-photon microscopy.
  • T cell migration to vascularized transplants.
  • Lymphoid neogenesis: a tribute to the travellers.
  • Intragraft tertiary lymphoid organs: friends and foes.