Midwest Regional Meeting Registration Information
The MidWEST SATA Meeting
Saturday, JANUARY, 21, 2023
08:55 Am – 12:30 PM (CST)
Course Syllabus
Program overview:
This SATA regional meeting will provide discussion of novel areas of interest in liver, heart, and lung transplantation.
Learning objectives:
At the end of this session participants will be able to:
- Determine the potential benefits and challenges of veno-venous bypass in liver transplantation
- Understand intraoperative management of recipients of DCD donation in liver transplantation
- Analyze the various vascular complications in the early postoperative period in lung transplantation
- Identify the role of new technology, including ex-vivo perfusion, in lung transplantation
- Understand changes in allocation policy in heart transplantation
- Assess intraoperative transesophageal echocardiography in patients undergoing heart transplantation
- Define the current state of DCD donation in heart transplantation
Target audience:
Anesthesiologists, intensivists, surgeons, fellows, resident, medical students, nurse anesthetists, advanced practice nurses, anesthesiologist assistants, physician assistants, and nursing staff who are involved in the perioperative care of transplant patients.
Faculty listing
Richa Dhawan, MD MPH Michael Essandoh, MD
Associate Professor Clinical Professor
Department of Anesthesia and Critical Care Department of Anesthesiology
University of Chicago, Chicago, IL Ohio State University, Columbus, OH
Mariya Geube, MD FASE Ivan Kangrga, MD PhD
Assistant Professor Professor
Department of Anesthesiology Department of Anesthesiology
Cleveland Clinic, Cleveland, OH Washington University, St.Louis, MO
Choy R. Lewis, MD Maria Lucia Madariaga, MD
Associate Professor Assistant Professor
Department of Anesthesiology Department of Surgery
Northwestern Medicine, Chicago, IL University of Chicago, Chicago, IL
Anthony L. Panos, MD Sudhakar Subramani, MD, MMed, FASE
Professor Clinical Associate Professor
Department of Surgery Department of Anesthesiology
University of Iowa, Iowa City, IA University of Iowa, Iowa City, IA
Tetsuro Sakai, MD, PhD, MHA, FASA Jeffrey Leighton Tong, MBChB
President SATA Associate Professor
Professor Department of Anesthesia and Critical Care
Department of Anesthesiology University of Chicago, Chicago, IL
University of Pittsburgh, Pittsburgh, PA
Kristin Trela, MD Andrea Vannucci, MD
Assistant Professor Associate Professor
Department of Anesthesia and Critical Care Department of Anesthesia and Critical Care
University of Chicago, Chicago, IL University of Chicago, Chicago, IL
Accreditation and CME credit designation:
SATA (The Society for the Advancement of Transplant Anesthesia), University of Pittsburgh Medical Center
Program organizing institution
University of Chicago (Meeting Chair: Richa Dhawan, MD MPH, FASE)
Platform:
https://us02web.zoom.us/j/88691487271?pwd=alhoNEsyRUdZYW1jcVN3SmRBa3NjZz09
Password will be provided upon registration below
Registration: Online Registration (Please complete your registration form for attendance purposes and to receive the hybrid link.)
Registration Fee:
- US $30.00 at registration to SATA (via above), if you need CME credits
- Free registration for:
- Current SATA members and members of the Society of Cardiovascular Anesthesiologists (SCA)
- Lecturers and moderators of the meeting
- Trainees, medical students, international medical personals, or nursing specialist who do not need CME credits
PROGRAM
8:55 – 9:00 AM Welcome and Introduction
Richa Dhawan MD, MPH
9:00 – 9:50 AM Liver Transplantation Session
(Moderator: Jeffrey Leighton Tong MBChB)
9:00 – 9:25 AM Use of veno-venous bypass in liver transplantation
Andrea Vannucci MD
9:25 – 9:50 AM Intraoperative management of a DCD liver transplant recipient
Ivan Kangrga MD, PhD
9:50 – 10:40 AM Lung Transplantation Session
(Moderator: Sudhakar Subramani MD, MMed)
9:50 – 10:15 AM The future of lung transplantation: New technology, ex-vivo perfusion and bioengineered lungs
Maria Lucia Madariaga MD
10:15 – 10:40 AM Vascular complications in lung transplantation
Michael Essandoh MD
10:40 – 10:50 AM SATA President Address
Tetsuro Sakai MD, PhD, MHA, FASA
10:50 – 11:05 AM BREAK
11:05 AM-12:20 PM Heart Transplantation Session
(Moderator: Kristin Trela MD & Richa Dhawan MD, MPH)
11:05 – 11: 30 AM Allocation policy, past, present, future
Anthony Panos MD
11:30 – 11: 50 AM Echocardiography assessment for heart transplantation
Mariya Geube MD
11:50 AM–12:20 PM Update on DCD donor donation
Choy Lewis MD
12:20-12:30 PM Closing Remarks
Richa Dhawan MD, MPH
Continuing Education Credit
In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician (CME)
The University of Pittsburgh designates this live activity for a maximum of TBA AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other Health Care Professionals
Other health care professionals will receive a certification of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.
Faculty Disclosure- TBD
All individuals in a position to control the content of this education activity including members of the planning committee, speakers, presenters, authors, and/or content reviewers have disclosed all relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients.
The following relevant financial relationships were disclosed:
- Tetsuro Sakai, MD, PhD, MHA (Haemonetics Inc. Research Grant)
No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.
Disclaimer Statement
The information presented at this CME program represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine. Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.
Click here to review the Program Agenda
Click here to Register for the SATA Midwest Regional Meeting
SATA Southeastern Regional Meeting – Thoracic Transplantation
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Login To have access to the Content!SATA Southeastern Regional Meeting – SATA Presidential Address
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Login To have access to the Content!SATA Southeastern Regional Meeting – Abdominal Transplantation
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Login To have access to the Content!SATA MidState Regional Meeting – Case Presentations
SATA MidState Regional Meeting – Case Presentations
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SATA MidState Regional Meeting – Current Dilemmas in Transplantation Session
SATA MidState Regional Meeting – Current Dilemmas in Transplantation Session
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SATA MidState Regional Meeting – Cardiopulmonary Considerations in Transplantation Session
SATA MidState Regional Meeting – Cardiopulmonary Considerations in Transplantation Session
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SATA MidState Regional Meeting – SATA Address
SATA MidState Regional Meeting – SATA Address
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September 2022 – Article of the Month
Factors Associated With Postreperfusion Syndrome in Living Donor Liver Transplantation: A Retrospective Study
Abstract
Background: Postreperfusion syndrome (PRS) after portal vein reperfusion during liver transplantation (LT) has been reported to cause rapid hemodynamic changes and is associated with a prolonged postoperative hospital stay, renal failure, and increased mortality. Although there are some reports on risk factors for PRS in brain-dead donor LT, there are a few reports on those in living donor LT. Therefore, we retrospectively reviewed the factors associated with PRS to contribute to the anesthetic management so as to reduce PRS during living donor LT.
Methods: After approval by the ethics committee of our institution, 250 patients aged ≥20 years who underwent living donor LT at our institution between January 2013 and September 2018 were included in the study. A decrease in mean arterial pressure of ≥30% within 5 minutes after portal vein reperfusion was defined as PRS, and estimates and odds ratio (OR) for PRS were calculated using logistic regression. The backward method was used for variable selection in the multivariable analysis.
Results: Serum calcium ion concentration before reperfusion (per 0.1 mmol/L increase; OR, 0.74; 95% confidence interval (CI), 0.60-0.95; P < .001), preoperative echocardiographic left ventricular end-diastolic diameter (per 1-mm increase: OR, 0.90; 95% CI, 0.85-0.95; P < .001, men [versus women: OR, 2.45; 95% CI, 1.26-4.75; P = .008]), mean pulmonary artery pressure before reperfusion (restricted cubic spline, P = .003), anhepatic period (restricted cubic spline, P = .02), and graft volume to standard liver volume ratio (restricted cubic spline, P = .03) were significantly associated with PRS.
Conclusions: In living donor LT, male sex and presence of small left ventricular end-diastolic diameter, large graft volume, and long anhepatic period are associated with PRS, and a high calcium ion concentration and low pulmonary artery pressure before reperfusion are negatively associated with PRS.
Comments by Scott Byram M.D.
Summary:
Hemodynamic management is often difficult and complex during orthotopic liver transplantation (OLT). One stage that can be particularly challenging to the anesthesiologist is the initiation of the neohepatic stage signaled by reperfusion of the liver graft. Post reperfusion syndrome (PRS) is known to cause rapid hemodynamic changes and is seen within minutes of opening the portal vein. The exact mechanism of PRS is still not understood, but is most likely multifactorial. PRS has been associated with several poor postoperative outcomes including renal failure, increased length of stay, and increased mortality.
In this retrospective study, the authors sought to identify risk factors for developing PRS after living donor (LD) OLT. Most prior studies on this topic have examined PRS with brain death donors. For this study, PRS was defined as a decrease in mean arterial pressure by more than 30% within 5 minutes of reperfusion that persisted for longer than 1 minute. 250 charts of LD OLT recipients were reviewed. Of these patients, 73 (29%) met the criteria for PRS. There were no significant baseline differences in sex, age, liver function, general condition, comorbidities, blood pressure, or medication between the two groups (PRS vs. non-PRS). Through multi-variable statistical analysis, the authors identified five significant risk factors for developing PRS. Characteristics associated with increased risk for PRS were: male sex, low left ventricular end-diastolic diameter on pre-op TTE, prolonged anhepatic duration, large graft volume, low ionized calcium just prior to reperfusion, and high mean pulmonary artery pressure (mPAP) just prior to reperfusion. These last two risk factors are particularly interesting because the anesthesiologist is able to modify both calcium concentration and mPAP prior to reperfusion, therefore potentially decreasing the risk for PRS.
The authors went on to speculate as to why these risk factors play a role in the development of PRS. However, they strongly cautioned readers not to assume that these associations were causative given the retrospective nature of this study. The ultimate conclusion of this paper was that these five factors could aid in predicting the probability of PRS, but randomized control trials would be needed to establish preventative strategies.
References
- Umehara K, Karashima Y, Yoshizumi T, Yamaura K. Factors Associated With Postreperfusion Syndrome in Living Donor Liver Transplantation: A Retrospective Study. Anesth Analg. 2022 Aug 1;135(2):354-361. doi: 10.1213/ANE.0000000000006002. Epub 2022 Jul 5. PMID: 35343925.