Acute on Chronic Liver Failure SIG: Management of the Critically Ill Cirrhotic Patient: Improving Multidisciplinary Care and Avoiding…

5 (1 vote)

Recorded On: 10/22/2017

Patients with acute-on-chronic liver failure frequently present to the ICU for care, and the mortality rate for cirrhotic patients requiring ICU approaches 50 percent.  Unique physiologic characteristics in the patient population warrant specialized, multidisciplinary, approaches to care.  The goal of this program is to further develop dialog between surgeons, hepatologists and intensive care unit teams to better deliver care to this complex patient population by focusing on the complex physiology of chronic liver failure.  In addition, we will devote special attention to areas of controversy in this patient group including initiation of renal replacement therapy, management of alcoholic hepatitis, defining futility and establishing appropriate goals of care.  

Constantine J. Karvellas

Constantine (Dean) Karvellas, MD, SM, FRCPC is an associate professor of medicine (Critical Care Medicine and Gastroenterology/Hepatology) at the University of Alberta and an adjunct professor in the School of Public Health Sciences. He has been an attending intensivist in the E. Garner King General Systems Intensive Care Unit since 2009 and is involved with the Liver Transplant program as a hepatologist.

Dr. Karvellas is the only Canadian co-investigator in the NIH-funded United States Acute Liver Failure study group (US ALFSG). He is also a Vice Chair of the Society of Critical Care Medicine (SCCM) Liver management task force and serves as an Associate Editor for the Journal of Hepatology. Dr. Karvellas’ publications reflect his interests in acute liver failure (ALF), acute on chronic liver failure (ACLF), liver transplantation and extracorporeal liver support.

Julia A. Wendon

Mitra K. Nadim

R. Todd Stravitz

Hugo E. Vargas

Hugo E. Vargas, MD, FAASLD is a Mayo Clinic Consultant in the Department of Gastroenterology and Hepatology and the Mayo Clinic Transplantation Center. He is the Medical Director for the Office of Clinical Research – Arizona, and a Professor of Medicine in the Mayo Clinic Alix School of Medicine. Dr. Vargas is the Chair of the Clinical Research Subcommittee, and the Vice Chair of the Arizona Research Operations Management Team.  

Dr. Vargas has authored or coauthored more than 125 peer-reviewed articles. He is a Fellow of the AASLD, AGA, ACG, ASGE and ACP. He has been active in AASLD and has chaired the Annual Meeting Education Committee, Ethics Commiteee and co-chaired the AASLD/IDSA HCV group from 2016 to 2018. 

Robert S. Rahimi

Jennifer C. Lai

Jennifer C. Lai, MD, MBA is a general/transplant hepatologist, associate professor of medicine at the University of California, San Francisco (UCSF) and director of the UCSF Advancing Research in Clinical Hepatology (ARCH) program. Her mission is to improve the lives of patients with end-stage liver disease both at an individual level—through exceptional patient-centered care—and at a system-wide level—through rigorous clinical investigation and effective dissemination of impactful research. Her research lies at the intersection of hepatology, liver transplantation, and geriatrics, focusing on the application of aging research principles to the care of liver transplant patients across their life-long journey from diagnosis of advanced chronic liver disease through long after liver transplantation. The foundation for her research is the NIH-funded Multi-Center Functional Assessment in Liver Transplantation (FrAILT) Study.

Dr. Lai earned her undergraduate degree from Stanford University and combined MD/MBA degrees from Tufts University. She completed residency at the New York Presbyterian Hospital-Columbia followed by gastroenterology and transplant hepatology fellowships at UCSF. She serves as Associate Editor for the American Journal of Transplantation, member for the Editorial Boards for HEPATOLOGY and for Liver Transplantation and standing member on the FDA Gastrointestinal Drug Advisory Committee.

Julie Heimbach

Julie K. Heimbach, M.D., is a Professor of Surgery and Chair of the Division of Transplantation Surgery at Mayo Clinic in Rochester, Minnesota.  She is currently on the council of the American Society of Transplant Surgeons; and recently served a member of the Governing Board of the AASLD and as chair of the Liver and Intestinal Transplant Committee of UNOS.   She also serves as associate editor of AJT and Journal of Hepatology.  Her interests are in liver transplantation in the setting of malignancy, particularly hilar cholangiocarcinoma, as well as the management of obesity in liver transplantation and living donor transplantation. 

Ayan Sen

Puneeta Tandon

Puneeta Tandon, MD, FRCPC is an associate professor of medicine, co-director of the Cirrhosis Care Clinic and transplant hepatologist at the University of Alberta in Edmonton, Alberta, Canada. She completed her internal medicine, hepatology and clinical epidemiology training at the University of Alberta with additional training at Yale University and the Hospital Clinic in Barcelona.

Dr. Tandon’s clinical practice and research are focused on cirrhosis with research interests including cirrhosis related complications, malnutrition, frailty, exercise therapy, palliative care and integrative health approaches such as meditation and behavior change techniques. It is her career goal to provide wholistic, interdisciplinary, patient-centered care through evidence, education, empowerment, engagement and teamwork.


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