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Program ORGANIZE:

Hospital Clinic Liver Transplant Unit

Renal Transplant Unit Transplant Coordination

V International Meeting on Living Donor Liver and Kidney Transplantation

Barcelona (Spain) November 21st 22 nd , 2007

Dear friends and colleagues,

Living donor kidney and liver transplantation continues to be a controversial issue to date.. Although the use of this type of organ transplantation is becoming more and more popular, this wide use involves, not only the development of the necessary surgical skills to do it, but also the need to develop awareness of the significance of this complicated process, inside or outside of the operating room, whether from the renal or the hepatic point of view. Thus the necessity to continuously evaluate the results achieved in the donor and the recipients side. The V International meeting on living donor organ transplantation will be specifically focused in promoting living organ donation and transplantation as well as evaluating the current results of the literature. This will be done by the most outstanding leaders of the world. Specifically, the role of the transplant coordinators , as well as the different models of organ living donation worldwide will be analysed. Controversial issues, such as laparoscopic donor nephrectomy with regard to kidney, or recurrence of HCV after transplantation with regard to liver, will be studied. Perhaps the most interesting aspects of this new course is that we include the transmission of two live procedures; an adult kidney and liver transplantations. Those very long procedures will be inserted during the development of the program, so that the most interesting parts of both operations could be easily viewed by the audience, without having to stand for the whole operation. Although it is widely acknowledged that living donation has emerged as an efficient means to help in reaching the highest number of patients, the Hospital Clínic, pioneer in Spain in this type of procedures, maintains its commitment and responds to the need for continued evaluation and maximum transparency, allowing the Society and the Scientific community to verify the advances achieved during this period as well as evaluate the problems associated to the whole process. In this occasion, the Hospital Clínic together with the Catalan Transplant Organization (OCATT) and the National Transplant Organization (ONT), under the patronage of the Department of Health of the Government of Catalunya, would like to give you a warm Welcome to Barcelona in the sureness that you will be getting, in this two days meeting, an overall view of living donation to date and its role in organ transplantation in the near future.

Juan C. García-Valdecasas Liver Transplant Unit

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Federico Oppenheimer Renal Transplant Unit

Antonio Alcaraz Department of Urology



HONOUR COMMITTEE:

President Marina Geli

Honorable Consellera de Sanitat

Rafael Matesanz National Transplant Organization (ONT)

Rosa Deulofeu Catalan Transplant Organization (OCATT)

ORGANIZING COMMITTEE:

HOSPITAL CLINIC: Transplant Coordination:

Martí Manyalich Jordi Vilardell

Liver Transplant Unit: Juan C. García-Valdecasas

José Fuster Ramón Charco

Constantino Fondevila

Renal Transplant Unit: Federico Oppenheimer

Antonio Alcaraz Rafael Gutiérrez Ricardo Álvarez

With the collaboration of:

Organización Nacional de Trasplantes (ONT) Organització Catalana de Trasplantaments(OCATT)

Sociedad Española de Nefrología (SEN) Sociedad Española de Trasplante Hepático.

Under the Patronage of the Conselleria de Sanitat de la Generalitat de Catalunya

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Invited Faculty

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Adam, Rene (Paris)

Alcaraz, Antonio (Barcelona) Alonso, Angel (A Coruña) Alvarez, Ricardo (Barcelona) Arias, Manuel (Santander) Ayuso, Juán Ramón (Barcelona) Belghiti, Jacques (Paris) Boggi, Ugo (Pisa) Burgos, Javier (Madrid) Campistol, José Mª (Barcelona) Charco, Ramón (Barcelona) Cofán, Federico (Barcelona) Cole, Edward (Toronto) De Carlis, Luciano (Milan) Escuin, Fernando (Madrid) Facundo, Carme (Barcelona) Fernández-Cruz, Laureano (Barcelona) Fondevila, Constantino (Barcelona) Foros, Xavier (Barcelona) Fuster, José (Barcelona) García-Valdecasas,Juan C. (Barcelona) Ghoneim, Mohamed A (Mansoura) Guirado, Lluis (Barcelona) Gutiérrez, Rafael (Barcelona) Gutiérrez, Alex (Barcelona) Hadengue, Antoine (Ginebra)

Hernández, Domingo (Tenerife) Llovet, José Maria (Barcelona) Line, Pal-Dag (Oslo) Lo, Cheng-Mau (Hong Kong) Malagó, Massimo (Essen) Manyalich, Marti (Barcelona) Matesanz, Rafael (Madrid) Mazzaferro, Vicenzo (Milán) Meneu, Juan Carlos (Madrid) Merion, Robert (Ann Arbor) Morales, José María (Madrid) Muntanya, Xavier (Barcelona) Navarro, Mercedes (Madrid) Navasa, Miguel (Barcelona) Oppenheimer, Federico (Barcelona) Pallardó, Lluis (Valencia) Pardo, Fernando (Pamplona) Plaza, Juan José (Madrid) Ricart, Assumpta (Barcelona) Rimola, Antonio (Barcelona) Rosales, Antonio (Barcelona) Sánchez-Fueyo, Alberto (Barcelona) Testa, Giuliano (Chicago) Troisi, Roberto (Gante) Vilardell, Jordi (Barcelona)



Scientific Program / Liver

KEY ISSUES

1. Retransmission of two live procedures Retransmisión de dos procedimientos en directo

2. Interactive Sessions on: Cases of the Real World Sesiones interactivas: Casos clínicos reales

3. Hands on Computer: - A total of 10 computers with 4 complete procedures (donor and

recipient) will be available. Specific place will be open during the whole course. Prácticas en el ordenador: 10 ordenadores con 4 procedimientos completos ( receptor y donante ) estarán disponibles. Habrá un lugar habilitado durante el curso

- Donor long term function Función en el donante a largo plazo

- Immunetolerance / Inmunotolerancia Besides, / Además For liver, / Hígado 4. HCV cirrhosis and LDLT / Cirrosis por HVC y VCH 5. HCC in LDLT / HCC en THDV 6. “Small for size” syndrome. Physiopathology and

experimental models. Síndrome de “SFS”. Modelo experimental y fisiopatología.

7. Results of the NIH collaborative study “A2ALL” Resultados del estudio A2ALL del NIH (Instituto Nacional de la Salud )

For Kidney,/ Riñón 8. ABO incompatibility. / Incompatibilidad ABO 9. Right kidney living donor / Donante vivo con riñón derecho 10. In severe vascular disease / Enfermedad vascular grave Registration: Surgeons interested in the Premeeting Course should specifically register, since only 10 computers (2 people per computer) will be available, in each type of procedure (kidney and liver) Los cirujanos interesados en el Curso Pre-Reunión deberán registrarse puntualmente ya que sólo estarán disponibles 10 ordenadores ( 2 personas por ordenador para riñón e hígado )

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WEDNESDAY November 21st

Pre-meeting Course on “Hands on Computer” Curso Pre-Reunión “Prácticas en el ordenador”

9:00-13:00 Introduction to “Hands on Computer” Individually review of 4 complete and detailed indexed operations. Revisión individual de 4 intervenciones completas.

For Liver / Hígado

Each procedure will include real time Intervention/ Cada Intervención es a tiempo real.

Donor operation: 1. Operative evaluation / Intervención Donante Evaluación intervención

2. Right liver isolation/ Aislamiento lóbulo derecho

3. Parenchimal Transection/ Transección del parénquima

4. Closing procedure / Proceso de cierre 5. How to avoid problems (portal vein kinking,

excessive hilium dissection, etc…) / Cómo evitar complicaciones (disección excesiva del hílio, torsión de la vena porta, etc.)

Recipient operation: 1. Hepatectomy / Hepatectomía Intervención Receptor 2. Liver implantation / Implante de Hígado

Portal vein anastomosis / Anastomosis vena porta Hepatic artery anastomosis / Anastomosis arteria hepática Bile duct anastomosis / Anastomosis vía biliar

3. Hemodynamics during the procedure Estudio hemodinámico

4. How to avoid problems (adequate venous drainage, excessive portal bloodflow, etc…) / Como evitar complicaciones (drenaje venoso adecuado, flujo portal excesivo,etc,)

13:00-15:00 Lunch / Comida

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Opening. State of the Art Lecture / Acto Inaugural. Conferencia Magistral

15:00-15:30 Living Donation in Spain Donación de vivo en España R. Matesanz (Madrid) (Organización Nacional de Trasplantes )

Session 1. European Living Donation and Public Health Project 2007 Donación Europea y Proyecto de Salud Pública 2007 Chairpersons / Moderadores: M. Manyalich (Barcelona) European Comission member

15:45-16:10 European Living donation and public health. La donación en vivo en Europa y salud pública. A.Ricart (Barcelona)

16:10-16:35 Living Donation in Europe Donación en vivo en Europa European Comission member

16:35-17:00 Living Donation in the world. Donación en vivo en el mundo World Health Organization member

17:00-17:30 Coffee Break / Descanso

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17:30-18:30 Clinical Cases / Casos Clínicos

Chairpersons / Moderadores: J.Vilardell (Barcelona) Pal-Dag Line (Oslo)

Clinical cases / Casos clínicos

Kidney/ Riñón Kidney. European / Riñón en países Europeos

Pal-Dag Line (Oslo)

Kidney. Non European / Riñón en países no EuropeosR. Merion (Ann Arbor)

Clinical cases / Casos clínicos Liver European / Hígado en países Europeos M. Navasa (Barcelona) Liver Non European / Hígado en países no Europeos G. Testa (Chicago)

Session 2. Immunological aspects of living donation and transplantation Aspectos inmunológicos de la donación y el trasplante de vivo . Chairpersons / Moderadores: M. González Molina (Málaga) R. Charco (Barcelona)

18:30-19:30 ABO incompatibility / Incompatibilidad ABO 19:30-19:50 Kidney / Riñón

F. Oppenheimer (Barcelona) 19:50-20:10 Liver / Hígado

R. Troisi (Gante)

/

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Liver/ Hígado




THURSDAY November, 22nd

RETRANSMISSION OF A LIVE PROCEDURE ALTERNATIVE CONNECTIONS TO FOLLOW THE WHOLE

PROCEDURE

Retrasmisión de un procedimiento en directo Conexiones intermitentes para el seguimiento del proceso completo.

Session 3. Evaluation of the living donor Evaluación del donante vivo Chairpersons / Moderadores: C. Fondevila (Barcelona) J. R. Ayuso (Barcelona)

8:00-8:20 “All in one” exploration.

Exploración complementaria “todo en uno” Magnetic resonance vs. multiplanar helicoidal TAC Resonancia magnética vs. TAC multiplanar helicoidal J. R. Ayuso (Barcelona)

8:20-8:40 Liver biopsy. Is it really needed ? Biopsia hepática: Es realmente necesaria?

A. Rimola (Barcelona) 8:40-9:30 Clinical Cases / Casos Clínicos

Clinical Case 1 / Caso Clínico 1 Portal vein variability – R. Troisi (Gante) Variabilidad de la vena porta Clinical Case 2 / Caso Clínico 2 Biliary tract variability – M. Malagó (Essen) Variabilidad tracto biliar Clinical Case 3 / Caso Clínico 3 Hepatic artery anomaly – F. Pardo (Pamplona) Anomalía arteria hepática.

Session 4. Recipient Considerations. Consideraciones del Receptor Chairpersons / Moderadores: M. Navasa (Barcelona) F. Pardo (Pamplona)

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9:30-9:45 Preparing the patient for transplant. The Kidney function (HRS Type I and Hyponatremia) and LDLT. Preparación del paciente para el trasplante. Función renal en la donación en vivo (HRS tipo I e hiponatremia) M. Navasa (Barcelona)

9:45-10:00 Clinical Case 4 / Caso Clínico 4 10:00-10:15 HCV Cirrhosis- Pre-Transplant Treatment.

Cirrosis por HVC. Tratamiento pre-trasplante. X. Forns (Barcelona)

10:15-10:30 Clinical Case 5 / Caso Clínico 5 10:30-11:00 Coffee Break / Descanso 11:00-11:15 Biliary Complications –Interventional Radiology

Treatment Complicaciones biliares – Tratamiento radiológico intervencionista. X. Muntanya (Barcelona)

11:15-11:30 Biliary Complications – Endoscopic Treatment

C.M Lo (Hong Kong) Complicaciones biliares – Tratamiento endoscópico

11:30-11:45 Clinical Case 6 / Caso Clínico 6 11:45-12:00 Biliary Complications – Surgical Treatment

Complicaciones biliares – Tratamiento quirúrgico M. Malagó (Essen)

12:00-12:15 Clinical Case 7 / Caso Clínico 7 12:15-12:30 Immediate Postoperative Immunosuppression

Postoperatorio inmediato. Inmunosupresión R. Charco (Barcelona)

12:30-12:45 Clinical Case 8 / Caso Clínico 8

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12:45-13:00 Prospects in Tolerance Induction

Perspectivas en la inducción de tolerancia. R. Troisi (Gante)

13 :00-13 :30 Biomarkers and Inmmunetolerance

Inmunotolerancia y biomarcadores A. Sánchez-Fueyo (Barcelona)

13:30-15:00 LUNCH / Almuerzo Session 5. Hepatocellular Carcinoma and LDLT

Trasplante hepático de donante vivo y carcinoma hepatocelular Chairpersons / Moderadores: J. M. Llovet (Barcelona) R. Merion (Ann Arbor)

15:00-15:20 Review of the current Knowledge of LDLT and HCC.

Revisión de la situación actual del hepatocarcinoma y trasplante hepático de donante vivo V. Mazzaferro (Milán)

15:20-15:40 LDLT vs DLT in HCC: Cost-effectiveness approach.

Donante vivo vs donante cadáver en hepatocarcinoma. Enfoque coste-eficacia A Hadengue (Geneva)

15:40-16:00 Extended HCC indications for LDLT. A critical

appraisal Ampliación de las indicaciones de donante vivo. Evaluación critica. J. M. Llovet (Barcelona)

16:00-16:20 Clinical Case 10 / Caso Clínico 10 16:20-16:30 NIH Collaborative Study. Preliminary data on

A2ALL in HCC. Estudio NIH. Resultados preliminares del estudio A2ALL en hepatocarcinoma Robert Merion (Ann Arbor)

16:30-16:45 Discussion / discusión

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16:45-17:00 Coffee Break / Descanso

Session 6 “Small for Size” Syndrome Sesión 6 - Síndrome SfS Chairpersons / Moderadores: J. Fuster (Barcelona) G. Testa (Chicago)

17:00-17:20 Experimental Model. Lessons Learned

Modelo experimental. Lecciones aprendidas. C. Fondevila (Barcelona)

17:30-17:50 Partial decompression and immediate function

Descompresión parcial y función inmediata. R. Troisi (Gante)

18:00-18:20 Perioperative hemodynamic response.

Prospective data Respuesta hemodinámica perioperatoria. Estudio prospectivo. J. C. García-Valdecasas (Barcelona)

18:30-18:45 “SFS” and the right upper quadrant

SfS e hipocondrio derecho. J. Belghiti (Paris)

Session 7. Surgical technique refinements Especificaciones de la técnica quirúrgica Chairpersons / Moderadores: J. C. Meneu (Madrid) L. De Carlis (Milán)

19:00-19:15 Venous Drainage. Not a big deal

Drenaje venoso. Problema fácil de resolver. M. Malagó (Essen) G. Testa (Chicago)

19:15-19:30 Hepatic artery. Easier than thought

Arteria hepática. Más sencillo de lo que parece. G. Testa (Chicago) M. Malago (Essen)

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19 :30-19:45 Bile duct reconstruction. Hepatojejunostomy vs. Duct to Duct Reconstrucción via biliar. Hepatoyeyunostomia vs. conducto-conducto M. Malago (Essen)

19 :45-20:15 Bile duct. To stent or not to stent

Vía biliar. Calibrar o no calibrar Pro and con Session / Sesión A favor – En contra Pro / A favor: G. Testa (Chicago) (10´) Con / En contra: CM Lo (Hong Kong) (10´)

Session 8. Results of Adult living donor liver transplantation Resultados del trasplante de hígado de donante vivo adulto. Chairpersons / Moderadores: J. Belghiti (Paris). J. C. García-Valdecasas (Barcelona)

18:15-18:30 Our experience / Nuestra experiencia

J. Fuster (Barcelona) 18:30-18:45 European Liver Transplant Registry

Registro Europeo de Trasplante Hepático R. Adam (Paris)

18:45-19:00 Asian Experience

Experiencia Asiática CM Lo (Hong Kong)

19:00-19:25 State of the Art Lecture NIH Collaborative Study.

A2ALL Results. Conferencia Magistral. Estudio NIH. Resultados A2ALL Donor and Recipient / Receptor y donante. Robert Merion (Ann Harbor)

19:25 19:30 Overall assessment / Valoración General.

Juan Carlos García-Valdecasas (Barcelona)

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GENERAL INFORMATION

Meeting Venue: Hotel: Hilton Barcelona Hotel

Avda. Diagonal 589-591 / 08014 - Barcelona Organizing Secretariat: OASIS VIAJES Y CONGRESOS, S.A. Director: Luis Micieces C/ Sor Ángela de la Cruz, 8 28020 Madrid – Spain Tele: +34 91 555 11 19 - Fax: +34 91 555 35 81 E-mail: [email protected] - Web: www.viajesoasis.com Information: All attendees must be registered. The organization kindly requests people attending the meeting to wear the badge to admission to the scientific sessions. Policy of Cancellation of Registration: All cancellations must be made in writing to the Secretariat. The refunds will be made after the meeting, cancellations made before 20th September having a refund of 75 % of the amount paid. No refund after mentioned date. Exhibition: Be sure to visit the exhibition during the meeting, informative and important components of this event provide you with a valuable opportunity to meet representatives from various International Companies that are committed to the field of the Hepatology and Nephrology Living Donor Transplantation. Multimedia Lounge: This room will be provided for speakers and presenters to prepare for their presentations. All speakers should check into this room with a minimum of one hour prior to starting the sessions. The meeting will provide standard audiovisuals equipment for PowerPoint presentation in all sessions. Meeting Language: English is the official language of the Meeting. All slides must be produced in the mentioned languaje. Cameras and Cell Phones: No cameras or video cameras will be allowed during the meeting. As a courtesy to fellow attendees kindly turn of cells phones. Certificate of attendance: This will be available for participants who request itat the Secretariat desk .

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Registration fee Before August 15, 2007 After August 16, 2007 Members ELTA Members ENA Trainees Premeeting Course

420 Euro 450 Euro 420 Euro 450 Euro 400 Euro 420 Euro 225 Euro 250 Euro

Hilton Barcelona 265 222

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ACKNOWLEDGEMENT

The Organizers acknowledge to all companies that have participated in this V International Meeting.

GOLD SPONSORS

ASTELLAS PHARMA

NOVARTIS

ROCHE

WYETH

SPONSORS

ABBOT LABORATORIES

ASTRAZENECA

B. BRAUN DEXON

BAYER

BAXTER

ETHICON

FRESENIUS

GENZYME

NYCOMED

PRIM

TYCO HEALTHCARE SPAIN



Scientific Program / Kidney


09:00-11:00 Diabetes mellitus and living donor kidney transplantation Diabetes mellitus y trasplante renal de donante vivo Chairpersons / Moderadores: L. Fernández-Cruz (Barcelona) M. Arias (Santander)

Evaluation criteria for living donors with impaired glucose metabolism Criterios para la evaluación clínica de donantes con alteración del metabolismo hidrocarbonado D. Hernández (Tenerife)

Preemptive transplantation for patients with diabetes-related kidney disease Trasplante renal anticipado en pacientes diabéticos NTBA

Living-donor kidney transplants in combination with simultaneous or sequential pancreas transplantation from deceased donor Trasplante renal de donante vivo y trasplante de páncreas simultáneo o secuencial U. Boggi (Pisa)

11:00-11:30 Coffee break / Pausa café 11:30-13:30 Current issues in living donor nephrectomy

Cirugía del trasplante renal de donante vivo Chairpersons / Moderadores: R. Alvarez (Barcelona) A. Rosales (Barcelona)

Retroperitoneoscopic donor nephrectomy Nefrectomía laparoscópica por vía retroperitoneal NTBA

Transperitoneoscopic donor nephrectomy Nefrectomía laparoscópica por vía transperitoneal R. Gutiérrez (Barcelona)





13:30 – 15:00

Technical alternatives for live donor right nephrectomy Nefrectomía derecha: alternativas técnicas NTBA The impact of the immunosuppression therapy on the surgical complications in kidney transplantation Influencia de la inmunosupresión en las complicaciones quirúrgicas del trasplante renal J. Burgos (Madrid) LUNCH / Almuerzo Acto Inaugural: Conferencia Magistral

15:00-15:30 Living Donation in Spain La donación de vivo en España R. Matesanz (Organización Nacional de Trasplantes)

Session 1. European Living Donation and Public Health

Project 2007 Donación Europea y Proyecto de Salud Pública 2007 Chairpersons / Moderadores: M. Manyalich (Barcelona) European Commission member

15:45-16:10 European Living Donation and Public Health.

La donación en vivo en Europa y salud pública A.Ricart (Barcelona)

16:10-16:35 Living Donation in Europe Donación en vivo en Europa.

European Commission member



Scientific Program / Kidney WEDNESDAY November 21st

16:35-17:00 Living Donation in the world Donante Vivo en el mundo

17:00-17:30 Coffee Break / Descanso 17:30-18:30 Clinical Cases / Casos Clínicos

Chairpersons / Moderadores: J.Vilardell (Barcelona) Pal-Dag Line (Oslo)

Clinical cases / Casos clínicos

Sessio 2. Inmunological aspects of living donation and

transplantation Aspectos inmunológicos de la donación y el

trasplante de vivo . Chairpersons / Moderadores:

M. González-Molina (Málaga) R. Charco (Barcelona)

18:30-19:30 ABO incompatibility 19:30-19:50 Kidney.

F. Oppenheimer (Barcelona) 19:50-20:10 Liver.

R. Troisi (Gante)

Kidney. European / Riñón en países Europeos Pal-Dag Line (Oslo)

Kidney. Non European / Riñón en países no Europeos R. Merion (Ann Arbor)

Clinical cases / Casos clínicos Liver European / Hígado en países Europeos M. Navasa (Barcelona) Liver Non European / Hígado en países no Europeos G. Testa (Chicago)

Liver/ Hígado

Kidney/ Riñón





08:30-10:30 Evaluation of living donor candidates Moderadores / Moderadores: L. Pallardó (Valencia) J. Burgos (Madrid)

Evaluation and selection of potential live kidney donors Valoración clínica de los candidatos a donación renal de vivo A. Ghoneim (Mansoura)

Connecting with the procedure – Case presentation Conexión en directo –Presentación del caso R. Gutiérrez. (Barcelona)

Evaluation of renal function in kidney donors candidates Valoración de la función renal en los candidatos a donación de vivo J.Mª Campistol (Barcelona)

Long-term preservation of renal function in elderly donors Preservación de la función renal a largo plazo en los donantes de edad avanzada F. Cofàn (Barcelona)

Connecting with the procedure. Conexión en directo con el procedimiento quirúrgico.

10:30-11:00 h. Coffee Break / Café 11:30-13:30 Kidney transplantation to patients with additional

risk conditions Trasplante renal de donante vivo a pacientes límite Chairpersons / Moderadores: JM Morales (Madrid) L. Guirado (Barcelona)





Living donor transplants to patients with diverse clinical risk factors Trasplante renal de donante vivo en pacientes con diferentes factores clínicos de riesgo. A. Gutiérrez (Barcelona)

Living donor kidney transplantation to elderly recipients Trasplante renal de donante vivo a receptores de edad avanzada E. Cole (Toronto)

Recurrence of focal segmental glomerulosclerosis after living-donor transplantation Recidiva de la hialinosis segmentaria y focal en el trasplante renal de donante vivo NTBA

Transplant surgery to patients with surgical riskfactors Alternativas quirúrgicas en receptores límite A. Alcaraz (Barcelona)

13:30-15:00 Lunch / Almuerzo 15:30 – 18:00 Experiencias actuales de los programas de

trasplante renal de donante vivo en España Chairpersons / Moderadores: J. J. Plaza (Madrid) F. Oppenheimer (Barcelona)

Base de datos de donante vivo C. Facundo (Barcelona)





Experiencias de los grupos españoles

Programas consolidados y programas emergentes

- Hospital Clinic de Barcelona F.Oppenheimer (Barcelona)

- Fundación Puigvert L. Guirado (Barcelona)

- La Paz Infantil M. Navarro (Madrid)

- Fundación Jiménez Diaz J. J. Plaza (Madrid)

- Hospital Juan Canalejo A. Alonso ( A Coruña)

- Hospital La Paz F. Escuin (Madrid)

- Hospital 12 Octubre J.Mª Morales (Madrid)

v international l transplantation - aopc · v international l meeting on nliving donor liver and...

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