
2018 Postgraduate Course: A Hectic Day for a Hepatology Consultant
Recorded On: 11/10/2018
The practice of Hepatology is largely consultative in nature, whether evaluating outpatients referred for a variety of abnormal liver enzyme findings or diagnosing and managing critically-ill patients within a team of internists, hospitalists, residents, intensivists, and other healthcare providers. On any given day, a hepatologist will be confronted with complex patients and dizzying differential diagnoses to be methodically considered. The aim of this course is to provide insights about state-of-the-art consultative Hepatology attendees that can be applied to daily practice.
2018 Postgraduate Course Enduring Release Dates:
- The Liver Meeting® 2018 Attendees: Immediately following The Liver Meeting®
- AASLD Members: February 1, 2019
- LiverLearning® Subscribers: March 1, 2019
Expiration Date: March 1, 2022
Core Competencies:
- Patient-centered Care
- Medical Knowledge
- Practice Based Learning and Improvement
- Interpersonal and Communication Skills
- Professionalism
- Work in Interdisciplinary Teams
- Employ Evidence-based Practice
- Roles/Responsibilities
- Interprofessional Communication
- Teams and Teamwork
Speakers
- Michael W. Fried, MD, FAASLD (Program Chair)
- Cynthia Levy, MD, FAASLD (Program Chair)
- Tse-Ling Fong, MD, FAASLD (Program Chair)
- Naga P. Chalasani, MD, FAASLD (Moderator)
- Rohit Loomba, MD (Moderator)
- Alfred Sidney Barritt, MD, MSCR
- Michael P. Manns, MD
- Heiner Wedemeyer, MD
- Mandana Khalili, MD
- Guadalupe Garcia-Tsao, MD, FAASLD (Moderator)
- Oren K. Fix, MD, MSc, FAASLD (Moderator)
- Kymberly Watt, MD
- Andres Cardenas, MD, MMSc, PhD, FAASLD
- Steven L. Flamm, MD
- Rajiv Jalan, MD, PhD, FRCP, FRCPE, FAASLD
- Vijay Shah, MD
- Laura M. Kulik, MD (Moderator)
- K. Rajender Reddy, MD, FAASLD (Moderator)
- Christopher L. Bowlus, MD, FAASLD
- Paul Y. Kwo, MD, FAASLD
- Lewis R. Roberts, MBChB, PhD, FAASLD
- Paul C. Adams, MD, FAASLD
- Mindie H. Nguyen, MD, MAS, FAASLD
- Robert S. Brown, MD, MPH, FAASLD (Moderator)
- Estella M. Alonso, MD, FAASLD (Moderator)
- Nancy Reau, MD, FAASLD
- Keyur Patel, MD
- Michael B. Fallon, MD, FAASLD
- Elizabeth Rand, MD
- Patrick S. Kamath, MD
Copyright: All faculty in this activity have given their permission for publication ©2018 AASLD.
Upon completion of this activity, participants will be able to:
- Differentiate presentations of complex liver diseases across different patient populations
- Apply best practices to diagnose and manage inpatients and outpatients with complex liver disease
- Communicate therapeutic recommendations to multiple healthcare providers encompassing the extended care team
Hepatologists
Gastroenterologists
Nurses
Nurse Practitioners
Pharmacists
Physician Assistants
Transplant Coordinators
Surgeons
Fellows/Trainees
Satisfactory completion
Participants must pass a post-test with a score of 70% or higher and complete an evaluation to receive a certificate of completion. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your board requirement.
CME
Accreditation Statement The American Association for the Study of Liver Diseases (AASLD) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation AASLD designates this enduring activity for a maximum of 6.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Maintenance of Certification
American Board of Internal Medicine (ABIM) MOC Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 6.75 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
American Board of Pediatrics (ABP) MOC Statement
Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participation and feedback to the participant, enables the participant to earn 6 MOC points in the American Board of Pediatrics (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.
MOC Points Process
- Physicians seeking MOC points must complete the CME evaluation in addition to viewing all of the presentation(s) and successfully passing the post-test(s) for each module with a score of 70% or better. MOC completions are collected on the 15th of each month and submitted to the ABIM and/or ABP by the last day of the month.
- Claiming of CME credits for the live course can be completed via The Liver Meeting® app or on AASLD's online CME claiming page.
- To claim MOC for attending the live 2018 Postgraduate Course, please visit the 2018 Postgraduate Course MOC activity.

Alfred Sidney Barritt

Michael P. Manns

Heiner Wedemeyer

Mandana Khalili
Kymberly Watt
Andres Cardenas
Dr. Andrés Cárdenas is currently a Consultant and Clinical Professor of the Institute of Digestive Diseases and Metabolism at Hospital Clinic and University of Barcelona. During his residency in Internal Medicine at Boston University Medical Center, he became interested in advanced liver disease, further pursuing a Research Fellowship in Hepatology for 2 years at Hospital Clinic and University of Barcelona in Spain. He returned to Harvard Medical School and BIDMC for his Clinical Fellowship in Gastroenterology and Hepatology. Dr. Cárdenas is Board Certified in Internal Medicine, Gastroenterology and Hepatology by the American Board of Internal Medicine. His main expertise and research interests are complications of cirrhosis, interventional procedures in patients with cirrhosis and portal hypertension and biliary complications in liver transplant recipients.

Steven L. Flamm

Rajiv Jalan

Vijay Shah
Christopher L. Bowlus
Dr. Christopher Bowlus obtained his medical degree at St. Louis University and completed his postgraduate training at University of California Davis and Yale University. Dr. Bowlus is Professor of Medicine and Chief of the Division of Gastroenterology and Hepatology at UC Davis. Dr. Bowlus conducts clinical and translational research in autoimmune liver diseases including primary biliary cholangitis and primary sclerosing cholangitis.
Paul Y. Kwo
Dr. Kwo is currently Professor of Medicine and Director of Hepatology at the Stanford University where he joined the faculty in November 2016. Prior to joining the faculty at Stanford, he was at Indiana University for 21 years where he served as the Medical Director of Liver Transplantation. He has distinguished himself in the field of chronic Hepatitis C and has a large practice devoted to current and novel therapies for the treatment of Hepatitis C. He has won multiple awards, both at the university, local, and national level.
Lewis R. Roberts
Dr. Lewis R. Roberts is the Peter and Frances Georgeson Professor in Gastroenterology Cancer Research and a Consultant in the Division of Gastroenterology and Hepatology at the Mayo Clinic, where he is Director of the Hepatobiliary Neoplasia Clinic, Co-Chair of the Hepatobiliary Cancer Disease Group of Mayo Clinic Cancer Center, Co-Principal Investigator of the Mayo Specialized Program of Research Excellence (SPORE) in Hepatobiliary Cancers, Associate Director of Pre-Doctoral Programs in the Center for Clinical and Translational Sciences, and Director for Research at Mayo Clinic Alix School of Medicine. Dr. Roberts earned his medical degree from the University of Ghana Medical School, a PhD in Physiology and Biophysics from The University of Iowa, and completed postgraduate training in Internal Medicine, Gastroenterology and Hepatology, and Cancer Genetics at Mayo Clinic.
Dr. Roberts clinical practice is focused on liver and biliary cancers. His research includes studies of the mechanisms of liver and biliary carcinogenesis; biomarkers to improve the diagnosis of liver, bile duct and pancreas cancers; and prevention, diagnosis and treatment of hepatitis and liver cancer. His research has been funded by NIH, The Robert Wood Johnson Foundation, the AGA Foundation, and The Cholangiocarcinoma Foundation. He has authored over 300 publications.
Dr. Roberts currently serves as Deputy Editor of HEPATOLOGY and is on the Editorial Boards of Liver Cancer and Hepatic Oncology.
Mindie H. Nguyen
Mindie Nguyen, MD is a professor of medicine and director for the Hepatology Fellowship and Clerkship in the Division of Gastroenterology and Hepatology and Liver Transplant at Stanford University Medical Center. She is an active clinician with a large general and transplant liver practice, and an active researcher in viral hepatitis, non-alcoholic fatty liver disease and liver cancer with over 250 publications including first or senior authorship in leading journals such as The New England Journal of Medicine, Lancet Gastroenterology and Hepatology, Gastroenterology, Journal of Hepatology and HEPATOLOGY.
Nguyen has served as editorial/advisory board member for major journals such as Lancet Gastroenterology and Hepatology, Gastroenterology and HEPATOLOGY. She is currently Chair of the Hepatitis B Special Interest Group for the American Association for the Study of Liver Diseases (AASLD) and an Officer/Treasurer and Executive Governing Council for the International Association for the Study of Liver Diseases (IASL). She is the lead Principal Investigator for several multinational studies involving over 40 centers in the U.S. and Asia Pacific. She serves as Board of Directors or Advisors for non-profit organizations locally and nationally in the U.S; and in collaboration with the local country Ministries of Health and Sports, she has directed scientific programs of continuing medical conferences for physicians in Mongolia and Myanmar. As an active teacher and educator, she has mentored over 130 trainees from high school students to undergraduate, medical, Masters’ and PhD students in Public Health/Epidemiology, clinical residents/fellows, postdoctoral research fellows, and faculty at Assistant/Associate Professor rank from Stanford University as well as other institutions in the U.S. and overseas.
Nancy S. Reau
Dr. Nancy Reau is currently Associate Director of Solid Organ Transplantation and Section Chief of Hepatology at Rush University Medical Center. Dr Reau’s research interest is in viral hepatitis drug development as well as utilisation. She has authored or co-authored over 100 peer-reviewed articles, invited reviews, editorials and online programmes, as well as several book chapters, and two books. She is the editor in chief for Clinical Liver Disease, the AASLD multimedia journal. She was one of the original authors of the AASLD/IDSA hepatitis C guidance document. She is currently a member of the steering committee for the hepatitis C special interest group for the AASLD and is a member of the gastroenterology writing committee for the American Board of Internal Medicine.

Keyur Patel

Michael B. Fallon

Elizabeth Rand

Patrick S. Kamath
Faculty, Planner and AASLD Staff Disclosures
This live educational activity has been planned in accordance with AASLD and ACCME Standards of Commercial Support by members of the AASLD Postgraduate Course faculty and the following planning committees: AASLD Education Committee, Scientific Program Committee, and the Governing Board.
As an accredited provider, AASLD requires individuals involved in the planning of continuing medical education (CME) activities to disclose all financial relationships, including those of their spouse or partner, with a commercial interest within the past 12 months. A commercial interest is defined as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. All conflicts of interest are resolved prior to participation.
Statement on off-label and investigational use: Speakers are asked to make a reasonable effort to identify during their presentation any discussion of off-label or investigative use or application of a product or device. Financial disclosures will appear at the beginning of each session and are provided below:
Postgraduate Course Faculty Disclosures
Paul C. Adams, MD, FAASLD
Consulting: Protagonist Therapeutics
Alfred Sidney Barritt IV, MD, MSCR
Advisory Committee or Review Panel: Target Pharmasolutions
Consulting: Dova Pharmaceuticals
Speaking and Teaching: SC Liver Research Consortium
Christopher L Bowlus, MD, FAASLD
Advisory Committee or Review Panel: BMS, Contatus, Cymabay
Consulting: Eli Lilly, BiomX
Grant/Research Support: TARGET Pharmasolutions, JKB Taiwan, Genkyotex, Takeda, Allergan, GSK, Arena, Gilead, Cymabay, Intercept Pharmaceuticals, Novartis, Eli Lilly
Andres Cardenas, MD, MMSc, PhD, FAASLD
Board Membership: Liver Transplantation Journal
Consulting: UptoDate
Grant/Research Support: Boston Scientifi
Michael B. Fallon, MD, FAASLD
Nothing to Disclose
Steven L. Flamm, MD
Consulting: Gilead, Abbvie, Merck, Salix, Intercept, Dova, Shonogi
Grant/Research Support: Gilead, Abbvie, Intercept
Rajiv Jalan, MD, PhD, FRCP, FRCPE, FAASLD
Consulting: Yaqrt Ltd
Grant/Research Support: Ocera Therapeutics Inc.
Patrick S Kamath, MD
Nothing to Disclose
Mandana Khalili, MD
Grant/Research Support: Gilead Sciences, Intercept Pharmaceuticals
Paul Yien Kwo, MD, FAASLD
Advisory Committee or Review Panel: Abbvie, BMS, Gilead, Merck, Shionogi, Dova, Durect, Janssen
Grant/Research Support: Abbvie, Gilead, Aurora, La Jolla Pharmaceuticals
Speaking and Teaching: Merck
Stock Shareholder: Durect
Michael P. Manns, MD
Advisory Committee or Review Panel: MSD - Merck Sharp & Dome, Abbvie, Novartis, Gilead, Bristol-MyersSquibb
Consulting: AbbVie, Gilead, Curevac, Eiger, Enyo Pharma, Falk Foundation, Intercept, Janssen, Medgenics, MSD - Merck, Novartis, GedeonRichter, Roche, Allergan, Preglem
Grant/Research Support: AbbVie, Gilead, Eiger, Intercept, J
Mindie H. Nguyen, MD, MAS, FAASLD
Advisory Committee or Review Panel: Gilead
Consulting: Spring Bank, Norvatis
Grant/Research Support: Gilead, B K Kee Foundation, NCI
Keyur Patel, MD
Advisory Committee or Review Panel: Gilead Sciences, Merck
Elizabeth Rand
Nothing to Disclose
Nancy Reau, MD, FAASLD
Nothing to Disclose
Lewis R. Roberts, MBChB, PhD, FAASLD
Advisory Committee or Review Panel: Bayer, Exact Sciences, TAVEC, Inc
Grant/Research Support: Gilead Sciences, Wake Diagnostics, Ariad Pharmaceuticals, BTG International, RedHill BioPharma
Vijay Shah, MD
Advisory Committee or Review Panel: Novartis Pharmaceuticals, Merck Research Laboratories, Afimmune, Ltd, Durect Corporation
Kymberly Watt, MD
Grant/Research Support: Gilead, Intercept
Heiner Wedemeyer, MD
Advisory Committee or Review Panel: Norgine, MSD, Janssen, Roche Diagnostic
Board Membership: Abbvie, Gilead
Consulting: Abbott, BMS, Eiger, MyrGmbH
Grant/Research Support: Abbott, BMS, Gilead, Roche Diagnsotics
Speaking and Teaching: Abbvie, Abbott, BMS, Gilead, Falk, Norgine, MSD
Planner Disclosures
Gavin E. Arteel, PhD, FAASLD (Scientific Program Committee)
Nothing to Disclose
Gyorgy Baffy, MD, PhD, FAASLD (Education Committee)
Nothing to Disclose
Jasmohan S. Bajaj, MD, MSc, FAASLD (Education Committee)
Consulting: Valeant, Norgine, and Abbott
Grant/Research Support: Salix, Grifols
Ramon Bataller, MD, PhD (Education Committee)
Speaking and Teaching: Echosens
Alex Befeler, MD (Scientific Program Committee)
Advisory Committees or Review Panels: Bayer, Gilead
Grant/Research Support: Mallinckrodt, Sillajen
Stock Shareholder: Amgen, Gilead
Jorge A. Bezerra, MD, FAASLD (Education Committee and Governing Board)
Grant/Research Support: Gilead, Molecular Genetics Laboratory, CHMC, Shier
Kyle E. Brown, MD, FAASLD (Education Committee)
Nothing to Disclose
Kimberly A. Brown, MD, FAASLD (Governing Board and Scientific Program Committee)
Advisory Committees or Review Panels: AbbVie, Bristol-Myers Squibb, CLDF, Gilead, Janssen, Merck
Grant/Research Support: AbbVie, Duke medical research, Gilead, Janssen, Merck, Novartix
Speaking and Teaching: CLDF
Elizabeth M. Brunt, MD, FAASLD (Education Committee)
Advisory Committees or Review Panels: Gilead
Andres Cardenas, MD, PhD, FAASLD (Education Committee)
Advisory Committees or Review Panels: Gilead
Amanda J. Chaney, DNP, ARNP, FNP-BC (Education Committee)
Nothing to Disclose
Raymond T. Chung, MD, FAASLD (Governing Board)
Advisory Committees or Review Panels: Alnylam
Grant/Research Support: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Gilead, Janssen, Merck
Mark J. Czaja, MD, FAASLD (Governing Board)
Consulting: Verlyx Pharma Inc.
Michael W. Fried, MD, FAASLD (Governing Board and Scientific Program Committee)
Consulting: AbbVie, Bristol-Myers Squibb, Gilead, Merck, TARGET PharmaSolutions
Grant/Research Support: AbbVie, Bristol-Myers Squibb, Gilead, Merck
Stock Shareholder: TARGET PharmaSolutions
Julie Heimbach, MD, FAASLD (Governing Board)
Nothing to Disclose
Patrick M. Horne, MSN, ARNP, FNP-BC (Scientific Program Committee)
Advisory Committees or Review Panels: AbbVie, Bristol-Myers Squibb, Chronic Liver Disease Foundation, Gilead Sciences, Merck
Wikrom Karnsakul, MD (Education Committee)
Nothing to Disclose
Andrew P. Keaveny, MD, FAASLD (Education Committee and Scientific Program Committee)
Independent Contractor: UpToDate Inc
Cynthia Levy, MD (Scientific Program Committee)
Advisory Committees or Review Panels: Target Pharmasolutions
Board Membership: Liver Transplantation
Consulting: Intercept, Novartis
Grant/Research Support: CymaBay, Gilead, Intercept, NGM, Novartis, Tobira
Speaking and Teaching: Medscape
Keith D. Lindor, MD, FAASLD (Governing Board)
Advisory Committees or Review Panels: Intercept, Shire
Anna S. Lok, MD, FAASLD (Governing Board and Scientific Program Committee)
Grant/Research Support: Bristol-Myers Squibb, Gilead, Target Solutions
Bruce A Luxon, MD, PhD, FAASLD (Governing Board)
Nothing to Disclose
John C. Magee, MD (Scientific Program Committee)
Nothing to Disclose
Mitchell A. Mah'moud, MD, FAASLD (Education Committee)
Nothing to Disclose
Richard A. Manch, MD, FAASLD (Education Committee)
Speaking and Teaching: Salix, Bayer, Gilead, AbbVie, Intecept
Lopa Mishra, MD, FAASLD (Governing Board)
Nothing to Disclose
David C. Mulligan, MD, FAASLD (Education Committee)
Nothing to Disclose
Mary K. Panther, BSN, RN, CGRN (Education Committee)
Stock Shareholder: Merck
K. Gautham Reddy, MD, FAASLD (Scientific Program Committee)
Advisory Committees or Review Panels: Gilead, Intercept
Grant/Research Support: Genfit, Intercept, Merck
Speaking and Teaching: Intercept
Ronald J. Sokol, MD, FAASLD (Governing Board and Scientific Program Committee)
Consulting: Alexion, Alnylam, Retrophin
Grant/Research Support: FFF Enterprises, Giliad, Shire/Lumena
Grace L. Su, MD, FAASLD (Education Committee)
Nothing to Disclose
Ayako Suzuki, MD, PhD, MSc (Education Committee)
Nothing to Disclose
Lisa B. VanWagner, MD, MSc (Education Committee)
Grant/Research Support: Novartis
Speaking and Teaching: Salix
Steven A. Weinman, MD, PhD, FAASLD (Education Committee)
Nothing to Disclose
Maria L. Yataco, MD (Education Committee)
Grant/Research Support: Genfit/Intercept
AASLD Staff Disclosures
Amy D'Amato
Nothing to Disclose
Katie Duggan
Nothing to Disclose
Steven Echard, IOM, CAE
Nothing to Disclose
Stephanie Grimsby
Nothing to Disclose
Jessica Jessop
Nothing to Disclose
Janeil C. Klett
Nothing to Disclose
Denise Seise
Nothing to Disclose
Session I: Morning Routine
MODERATORS: Naga P. Chalasani, MD, FAASLD and Rohit Loomba, MD
8:00 - 8:10 AM A Hectic Day in the Life of a Hepatology Consultant
Welcome/Qualities of a Valued Consultant
8:10 - 8:30 AM Abnormal Liver Enzymes in a Patient with Diabetes
Alfred Sidney Barritt, MD, MSCR
8:30- 8:50 AM Hepatitis C in a 23-year-old who Injects Drugs
Michael P. Manns, MD
8:50 - 9:10 AM Abnormal Liver Enzymes and Recurrent UTI in a 67-year-old Woman
Heiner Wedemeyer, MD
9:10 – 9:30 am HBV/HCV Coinfection in a Pregnant Woman
Mandana Khalili, MD
9:30 – 9:50 am Break
Session II: Rounds in the MICU
MODERATORS: Guadalupe Garcia-Tsao, MD, FAASLD and Oren K. Fix, MD, MSc, FAASLD
9:50 - 10:10 AM Fever and Elevated Liver Enzymes in a Liver Transplant Recipient
Kymberly Watt, MD
10:10 - 10:30 AM Massive GI Bleeding in a Patient with Cirrhosis: What’s New?
Andres Cardenas, MD, MMSc, PhD, FAASLD
10:30 - 10:50 AM Altered Mental Status in a Patient with Refractory Ascites
Steven L. Flamm, MD
10:50 – 11:10 AM Acute Liver Failure in a 26-year-old Woman
Rajiv Jalan, MD, PhD, FRCP, FRCPE, FAASLD
11:10 - 11:30 AM Jaundice and Renal Failure in a Patient with Alcoholic Cirrhosis
Vijay Shah, MD
11:30 - 11:40 AM Break
11:40 - 1:05 PM Intermission/Meet-the-Professor Luncheons
Session III: Meanwhile, Back in the Office…
MODERATORS: Laura M. Kulik, MD and K. Rajender Reddy, MD, FAASLD
1:05 - 1:25 PM Cholestatic Liver Abnormalities in a 52-year-old African American Woman
Christopher L. Bowlus, MD, FAASLD
1:25 – 1:45 pm Multiple Liver Masses in a 42-year-old Woman Advances in the Diagnosis of Hepatobiliary Neoplasia
Paul Y. Kwo, MD, FAASLD
1:45 – 2:05 pm A 1.9 cm HCC in a Patient with HCV Cirrhosis
Lewis R. Roberts, MBChB, PhD, FAASLD
2:05 – 2:25 pm “My Brother Was Just Told He Had Too Much Iron in His Blood”
Paul C. Adams, MD, FAASLD
2:25 – 2:45 pm A Patient with Crohn’s Disease and HBcAb+
Mindie H. Nguyen, MD, MAS, FAASLD
2:45 – 3:05 pm Break
Session IV: Exploring Other Units at Dusk
MODERATORS: Robert S. Brown, MD, MPH, FAASLD and Estella M. Alonso, MD, FAASLD
3:05 – 3:25 pm Hyperbilirubinemia in Labor and Delivery
Nancy Reau, MD, FAASLD
3:25 – 3:45 pm Hyperbilirubinemia in a Patient after Bone Marrow Transplant
Keyur Patel, MD
3:45 – 4:05 pm A 60-year-old in CCU with Jaundice
Michael B. Fallon, MD, FAASLD
4:05 – 4:25 pm A 14-year-old Child s/p Fontan Procedure with Liver Abnormalities
Elizabeth Rand, MD
4:25 – 4:45 pm Acute Right Upper Quadrant Pain in a Patient with Cirrhosis
Patrick S. Kamath, MD
4:45 – 5:00 pm Wrap Up
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