Heart Transplantation

Luciano Potena: December 2017

Heart Transplantation General

0 CME Credits 

  • Heart transplantation from non heart beating donors (Hendrik T. Tevaearai Stahel)
  • Literature (By Ivan Knezevic)
  • The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update (Various contributors)
  • Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management (Various contributors)
  • Report from a consensus conference on antibody-mediated rejection in heart transplantation (Various contributors)
  • Heart Transplantaion E-Book (Cristiano Amarelli)

Heart Transplantation Module 1

3 CME Credits 

Indications for heart transplantation: screening and listing of transplant candidates (Maria Frigerio)
  • The framework: Need, risk factors, availability, concurrent and alternative options
  • Evaluation of the chronic patient: Summary of updated ISHLT guidelines
  • Evaluation of the chronic patient: Cardiological workup
  • Evaluation of the chronic patient: Prognostication in advanced heart failure
  • Evaluation of the chronic patient: Non-cardiac workup
  • Evaluation of the chronic patient: Survival after transplantation and risk factors
  • Evaluation of the acute/de novo patient
  • Follow-up and management on the waiting list
Management of bi-ventricular assist device (ECMO-TAH-BIVAD) in the waiting list patient. (Cristiano Amarelli)
  • Clinical context: pathophysiology over right ventricular dysfunction
  • Clinical context: End organ dysfunction
  • Available devices: Bridge to decision policy
  • Available devices: Total artificial heart vs BiVAD
  • Role of IABP
  • Case & conclusions
Cardiac procurement (Ivan Knezevic)
  • Donor heart inspection
  • Donor heart harvesting
Cardiac preservation (Ivan Knezevic)
  • Overview of preservation
  • Cold static preservation
  • Machine perfusion preservation
Allocation strategies: which organ for which recipient (Andreas Zuckermann)
  • Donor selection: Waiting times and donor situation in Europe
  • Donor selection: Donor selection
  • Donor selection: Donor age and echo
  • Donor selection: Hypotrophic and CAD
  • Donor selection: Donor risk scores
Cardiac implantation (Andreas Zuckermann)
  • Preparation of recipient
  • Native heart excision
  • Donor heart preparation
  • Implantation technique
  • Finishing & complications
Indications for transplant: screening and listing of transplant candidate - Case Development (Josebe Goirigolzarri)
  • Indications for transplant: Screening and listing of transplant candidate
  • Right heart catheterization and comorbidities
  • Pulmonary hypertension management
  • INTERMACS III strategies and how the case ends
Selecting patients for LVAD implantation: troubles and hopes of an heart failure cardiologist: Case 1 (Marco Masetti)
  • Introduction to LVAD
  • Case 1: Urgent or not? Complicated LVAD on the waiting list
  • Case 1: Complications
  • Case 1: Solution

Heart Transplantation Module 2

3 CME Credits 

Heart Transplantation - Surgical Procedures (Ivan Knezevic)
  • Donor heart harvesting: Tricks & tips
  • The heart recipient operation: Tricks & tips
  • Donor heart implantation - bicaval technique: Tricks & tips
Immunosuppression in heart transplantation (Luciano Potena)
  • General principles of immunosuppression in heart transplantation
  • Induction therapy
  • Maintenance therapy
  • Long term therapeutic objectives
  • Key principles and learnings
Theatre Lecture: Journey of a Biopsy: Part I (Luciano Potena)
  • Journey of a Biopsy: Part I
Lab Lecture: Journey of a Biopsy: Part II (Ornella Leone)
  • Technical preparation of the biopsy
  • Pathology of cardiac rejection
  • Case 1: Negative for rejection
  • Case 2: Moderate rejection
  • Case 3: Mild rejection
  • Case 4: Antibody mediated rejection
  • Case 5: Mixed rejection
Heart transplants in patients with congenital heart disease and previous palliative procedures (Daniel Zimpfer)
  • Morphology and Anatomy
  • Donor selection and organ procurement
  • Transplant procedure
  • Reconstruction of central pulmonary arteries and venous return
Selecting patients for LVAD implantation: troubles and hopes of an heart failure cardiologist: Case 2 (Marco Masetti)
  • Case 2: Severe pulmonary hypertension in transplant candidate - end of the story?
  • Case 2: Solution
Selecting patients for LVAD implantation: troubles and hopes of an heart failure cardiologist: Case 3 (Marco Masetti)
  • Case 3: Cardiogenic shock of 20 year old female soccer player with recent cancer
  • Case 3: Solution & RV failure

Heart Transplantation Module 3

2 CME Credits 

Transplantation in congenital heart disease (CHD) in pediatric and adult patients - Indication, Timing, Pre-operative diagnostics (Martin Schweiger)
  • Main reasons for HT in CHD
  • Special considerations for HT in CHD
  • ACHD
  • Failing Fontan
Early management: preventing, recognising and managing complications (Nick Banner)
  • Background of heart transplantation with complications
  • Casestudy introduction
  • Circulatory failure after heart transplantation
  • Allograft dysfunction - definition and existing assessment models
  • Allograft dysfunction - a different view
Long term management and complications: Case Presentation (Josebe Goirigolzarri)
  • Long term management and complications: Infections and IS
  • CMV initial management
  • Drug resistant CMV
  • Immunosuppresion: Introduction
  • Immunosuppresion: General principles
Long term management and complications: Case Presentation (Josebe Goirigolzarri)
  • Long term management and complications: CAD and rejection
  • AMR diagnosis in our patient
  • Brief lecture of AMR: Risks, diagnosis and treatment