Focussed Group Discussion - Alcohol use disorder in liver disease
🗓️ 21 Nov 2025🕒 08:00 - 08:45📍Hall C
Theme - Focussed Group Discussion
Objectives -
Focussed Group Discussion - Alcohol use disorder in liver disease
1. Anti craving drugs: do they really work? 2. Role of Counselling for reducing heavy drinking. 3. Managing withdrawal syndrome(s) in admitted patients. 4. Role of Thiamine in patients with AUD. 5. Nutritional assessment and management .
Theme - Balancing Risks and Benefits in Pediatric Metabolic Disorders
Objectives -
1. Explore the concept and rationale of preventive liver transplantation (before overt liver failure or irreversible complications) 2. Discuss disease-specific indications: Crigler–Najjar syndrome type 1 (CN1), primary hyperoxaluria, and urea cycle disorders (UCD) 3. Explore the role of specific genetic factors (e.g., DCD2 gene, NSC variants, NBAS gene) in transplant decision-making
Disease-Specific Rationale: CN1, primary hyperoxaluria, and UCD – When to consider early/preventive transplant
Theme - From Dietary Management to Transplantation Decisions
Objectives -
1. Provide an overview of liver transplantation in amino acid disorders and organic acidemias (MMA, PA, MSUD, UCD) 2. Highlight real-world experience through case discussion 3. Deciding the timing of transplant -failure of dietary management 4. Understand long-term outcomes and follow-up challenges in these patients
Indications for liver transplantation in Amino acid and Organic acid disorders; Pathophysiology and Rationale
Real-world case: Diagnostic journey, metabolic crisis management, and transplant decision
Sub Topics: 1) Management of metabolic crisis 2) When is dietary management sufficient? 3) When should liver transplantation be considered? 4) Pros, cons, and ethical dilemmas
Theme - Balancing Dietary Therapy, Growth, and Transplant Timing
Objectives -
1. Provide an overview of liver transplantation in carbohydrate metabolism disorders 2. Explore case-based dilemmas where extrahepatic involvement (e.g., cardiac disease) or growth failure drives decision-making 3. Discuss failure of dietary management and timing of liver transplantation 4. Discuss strategies for optimizing long-term outcomes after transplant
Indications for liver transplantation in disorders of carbohydrate metabolism (e.g., GSD, galactosemia, hereditary fructose intolerance)
Sub Topics: 1) Dietary Management - When is strict dietary management sufficient? when do you call "failure of dietary management" 2) Growth failure as a sole indication 3) Assessment of extrahepatic disease in transplant candidates (Renal, Muscular) 4) Oncovigilance & role of SGLT2- inhibitors
Theme - The Key to key-hole surgery: The Ying and Yang of Minimal Invasive/Robotic Surgery
Objectives -
1. Understand the learning curve vis a vis technology 2. Requirements of Setting up of the minimally invasive/Robotic unit and Mentorship 3. Understanding the difference between misadventure versus retreat 4. Understand the importance and relevance of laparoscopic surgery
Robotic Donor Surgery: The learning curve and beyond
1. Define ACLF using current classifications (EASL vs APASL). 2. Explore immunologic and clinical course of ACLF patients. 3. Evaluate the role of extracorporeal therapies in improving outcomes.
Theme - ACLF & Liver Transplantation: Who Makes the Cut?
Objectives -
1. Identify which ACLF patients benefit from liver transplantation. 2. Explore diagnostic dilemmas and management strategies in diabetic ACLF cases. 3. Engage in interactive, case-based learning on ACLF treatment pathways.
Which ACLF Needs a Liver Transplant? Identifying key clinical and prognostic markers for transplant candidacy in ACLF
Theme - Peri-Transplant management of ACLF: Challenges and Holistic Strategies
Objectives -
1. Recognize challenges of ACLF in post-transplant patients. 2. Discuss holistic strategies for alcohol-related ACLF cases. 3. Analyze transplant and non-transplant outcomes and relapse prevention.
Challenges in Managing ACLF 3 Post-Transplant: Clinical course and complications in early post-Liver Transplantation period
Theme - Deciphering elusive portal hemodynamic and its management
Objectives -
1. Understanding the basic physiology and underlying principles. 2. Insight into the intraoperative portal flow management. 3. Scrutinizing the newer evidence.
Theme - The Final Verdict: Understanding pathologic basis of disease(s)
Objectives -
• Case based discussion to understand real life problem • Approach to patient with post liver transplant graft dysfunction • Deciphering pathological changes in the graft and its interpretation
Theme - Blending Surgical Precision with Digital Illustration.
Objectives -
Learning the implementation of Procreate app in iPad for drawing diagrams in layers for better understanding of surgical anatomy and it’s use in teaching, learning, surgical planning Etc.
Basics of using procreate app, layering, annotation Etc
• To understand the immunological principles of ABOi Liver Transplantation. • To explore evolving trends and long-term outcomes in ABOi Liver Transplantation. • To apply desensitization and management strategies in complex cases.
B Cell Immunology in ABO-Incompatible Liver Transplantation: Mechanisms, Monitoring, and Modulation
1. Review current indications and contraindications for PVR-TIPS 2. Discuss technical advances in portal vein recanalization 3. Highlight clinical outcomes, complications, and long-term follow-up 4. Present real-world case studies and multidisciplinary perspectives
From Blocked Pathways to New Lifelines: The Journey of PVR-TIPS
Case based Panel Discussion: 30 yr male with child A cirrhosis have AST and ALT of 600IU/550 IU /ml
Sub-topics: 1. What are the most likely causes of such high transaminase levels in a patient with known Child-Pugh A cirrhosis? 2. Are there any infectious or autoimmune etiologies that need to be considered and investigated further? 3. Herbal supplements, or other drugs leading to this scenario? 4. Work up for cryptogenic cirrhosis 5. Role of Liver Biopsy in this patient 6. Algorithm for work up
• To highlight unique desensitization strategies in pediatric ABOi Liver Transplantation. • To discuss management of emergency ABOi transplants. • To differentiate AMR in ABO-compatible vs. ABO-incompatible Liver Transplantation.
• Showcase cutting-edge intra-op IR techniques that redefine hepatobiliary surgery. • Explore real-time rescue strategies for vascular and biliary complications. • Discuss intra-op precision tools for safer and more effective interventions. • Highlight next-gen techniques like thrombolysis, maceration, and aneurysm control. • Inspire future-ready practice with hybrid ORs and intra-op imaging.
Scalpel Meets Catheter: The Hybrid Era of Intra-Op IR
Case based Panel Discussion: 39 yr old female diagnosed as PBC and intractable pruritus, LFTs shows ALT 880IU/ ml
Sub-topics: 1. Differentials for High ALT levels in PBC patient. 2. Diagnosis of overlap syndrome? Newer scoring system. 3. Role of AI in diagnsosis of PBC-AIH. 4. Prognosis in comparison to AIH alone. 5. Management strategy in this patient (including pruritus), Role of Liver Transplantation
Theme - Scoring Systems, Prognostic Models, and Perioperative Challenges
Objectives -
1. Understand the role of scoring systems and prognostic models in timely decision-making for LT in pediatric ALF 2. Review a case journey from ALF diagnosis to LT and postoperative care 3. Decide critical issues in timing and candidate selection for transplant in ALF 4. Learn about perioperative hemodynamic monitoring and critical care in PALF 5. Discuss novel therapies and evolving strategies in PALF management
Prognostic Modeling in PALF: Diagnostic criteria and efficient use of scoring systems (e.g., King’s College, Clichy, Liver Injury Units, PALF-specific models, NWI) to guide transplant decisions
Theme - AKI in cirrhosis: A spectrum, not a single snapshot
Objectives -
1. To learn about updates on AKI in cirrhosis 2. To understand management of AKI in cirrhosis with real world case discussion 3. To understand complete spectrum of Kidney dysfunction in cirrhosis
Case-Based Panel Discussion: A 45 year old decompensated cirrhotic male presented with decreased urine output. There is h/o recent ascitic tap. His serum creatinine is 2.8mg%. pretransplant management strategies
Sub Topics:
1. Discuss post ascitic tap PICD, risk factors, serum markers, prevention beyond albumin
2. Approach to AKI in this patient
3. When to start terlipressin
4. Terlipressin doesn’t work in 50% of patients with HRS- how to optimize these patients.
5. Liver Transplantation is cure for HRS- Is there any cut off of creatinine beyond which Liver Transplantation alone should not be done
Theme - From Survival to Recovery: Overcoming Malabsorption and Fueling Growth
Objectives -
1. Review the role of TPN and enteral feeding in the immediate post-transplant phase 2. Explore the causes and management of diarrhea, malabsorption, and feeding intolerance 3. Discuss strategies to induce anabolism and optimize growth post-transplant 4. Understand monitoring and adjusting nutritional interventions in the long-term
Feeding the Fragile Gut: Post transplant feeding challenges: fluid restriction, immunosuppression-induced metabolic issues, enteral vs. parenteral nutrition (immunosuppressants, infections, bile salt malabsorption, pancreatic insufficiency), diagnostic approach, and dietary interventions
Beyond Calories: Long-term growth monitoring, catch-up growth, and puberty considerations, Long-term nutrition: preventing obesity, metabolic syndrome, sarcopenia, and bone loss
1. Review tools to assess sarcopenia and frailty in cirrhosis and their role in transplant evaluation. 2. Understand how sarcopenia and refractory ascites influence liver transplant outcomes. 3. Explore prehabilitation strategies to improve post-transplant recovery and survival.
Integrating ascites and sarcopenia in transplant decision-making: Role of assessment tools
Pre Liver Transplantation rehabilitation: Prehabilitation approach in Liver Transplant recipients and its impact on Post Liver Transplantation outcomes
Case: “Refractory Ascites in Cirrhosis: Managing Beyond Diuretics” Sub-topics: 1) Pathophysiology and modern management strategies (TIPS, albumin infusions, vasoconstrictors). 2) When to bridge to transplant and when to delist. 3) Impact of refractory ascites on perioperative mortality.
Theme - Navigate ALF with Precision: Etiological Patterns, ICU Care, Dynamic Scores, and Transplant Readiness
Objectives -
1. Discuss recent changes in etiological pattern of ALF. 2. Discuss natural history of DILI related ALF and need for early transplant. 3. Analyze need and advantages of dynamic scoring over KCC for transplant in ALF. 4. To learn about dynamics and outcomes of hyperacute ALF 5. Managing ALF intraop during LT surgical and anaesthetic perspectives"
Case-Based Panel Discussion: 27 F with HAV related hyperacute ALF admitted in liver ICU: care/monitoring/ALSS/Tx Listing
Sub topics 1. ALF in emergency department- Things to do 2. ICU care of ALF patient (when to MV, ICP monitoring, Nutrition, Antibiotics/ antifungals of choice) 3. Artificial liver support system (Plasma exchange/CRRT)- Patient selection, prevention of infections, CRRT first or plasma exchange- how to decide) 4. Does Dynamic scores help in deciding for Liver Transplant listing
Case based Panel Discussion: 45 y old lady with child B cirrhosis, detected to have partial PV thrombosis on screening USG
Sub-topics: 1. Further assessment- CT triple phase role, Procoagulant workup. Variceal screening (before anti coagulants) 2. Indication for anti-coagulants? 3. In case of < 30% luminal compromise how will you monitor this patient? 4. Challenges in Liver Transplantation in this patient
Theme - Navigating the Metabolic Maze: MASLD and Liver Transplant Outcomes
Objectives -
1. To understand how Metabolic mayhem fuels the MASLD fire 2. To gain insights in optimizing MASLD donor 3. To understand pre op assessment & optimization of morbidly obese cirrhotic undergoing Liver Transplantation with case based panel discussion
Case based Panel Discussion: 58 yr old morbidly obese cirrhotic (MELD 20) planned for Liver Transplantation. Risk assessment and optimizing for Liver Transplantation
Sub-topics:
1. Morbid obesity and potential donor-recipient mismatch, in living donor LT (LDLT)?
2. What are the potential perioperative and post-transplant complications associated with obesity in this specific case?
3. Does the presence of sarcopenia (muscle wasting), along with obesity (sarcopenic obesity), further impact prognosis and potential post-LT complications?
4. What are the most appropriate and effective weight loss strategies for this patient, considering the liver function and potential risks of worsening malnutrition or sarcopenia? Does GLP1 agonist have any role?
5. If considering bariatric surgery, what are the optimal timing (before, during, or after LT) and the most appropriate surgical approach (e.g., sleeve gastrectomy), weighing the benefits and risks in this specific clinical context?
