NASPGHAN 2019 chronic liver disease symposium provides update for GIs

CHICAGO — During this year’s North American Society for Pediatric Gastroenterology, Hepatology & Nutrition annual meeting, Mercedes Martinez, MD, from the New York-Presbyterian Columbia University Irving Medical Center in New York, will co-host the Single Topic Symposium on Chronic Liver Disease Management for the Gastroenterologist.

Healio Gastroenterology and Liver Disease spoke with Martinez about the topics covered in the symposium, including improved diagnostics, new therapeutics, management of portal hypertension, and liver transplantation.

“We are going to cover a broad number of topics in hepatology and liver transplantation that are very relevant for the general gastroenterologist, presented by a group of well-renowned speakers,” Martinez said in an interview. “The symposium was designed to review state of the art management of these conditions for the general gastroenterologist, but I do think hepatology specialists would also greatly benefit from the recent scientific research that will be presented.”

The first session on “Diagnostic Challenges in Pediatric Liver Disease” will include sessions on evaluating cholestasis in pediatric patients, interpreting genetic results and abnormal radiology findings, along with a lecture the evaluation of on abnormal liver enzymes.

“This session will focus on teaching the general gastroenterologist how to approach common liver diseases in the office,” Martinez said. “We will also highlight the recent advances in genetic tests, which will soon become part of standard clinical care.”

The second session, “Frontiers in Liver Therapeutics,” begins with a lecture on the overall approach of clinical-oriented research and how to improve the status quo of patient management, which will eventually lead to improved quality of life.

“The other three lectures in the second session will provide examples of how far we’ve come in the management of common and life-threatening liver diseases from acute liver failure, to viral hepatitis, to nonalcoholic steatohepatitis. The therapeutic interventions presented during these talks have been generated by pediatric focus research, which is tremendous,” Martinez continued.

The third session will provide an “Update on Portal Hypertension” from assessment to management, which Martinez explained could occur in either patients reaching the end stage of any chronic liver disease or patients without cirrhosis who otherwise present with vascular problems. She highlighted this session as important for gastroenterologists because it covers the management of complex patients by gastroenterologists but also features the importance of a multidisciplinary approach. Two talks include the role of the interventional radiologists and surgeons in the most complex cases.

The lectures in the final session, “Liver Transplant: Pre- and Post-Transplant Considerations,” will provide a sequence of operation starting at determining the need for transplant, management of a patient waiting for an organ, and deciding which type of organ — living donor vs. deceased donor — would be best based on patient health status and donor availability.

“These are important topics that any physician involved in the care of patients with liver disease should be aware,” Martinez said. “While a liver transplant will save the patient’s life, the need for life-long monitoring and immunosuppression as well as issues related to organ rejection, biliary and vascular complications can affect a patient’s quality of life, alter family dynamics, and present an economic burden to society. However, a liver transplant will improve the patient’s quality of life through long-term normality, allowing them to go to school or to work.”

She was also excited about the other hepatology-focused sessions during the rest of the meeting, discussing two real-world cases of difficult-to-diagnose liver diseases, postgraduate courses on NAFLD and chronic cholestasis, and further updates on managing pediatric patients.

“The rest of the sessions will be fantastic. Experts involved in the development of improved diagnostic tools will present data on noninvasive markers of hepatic fibrosis and state-of-the-art management after liver transplant supported by evidence-based data. At completion, participants will be prepared to diagnose, treat and refer a patient with complex liver disease in a timely manner,” she concluded.

Healio Gastroenterology and Liver Disease staff will report live on breaking news presented at the meeting and gain expert perspectives on important presentations. Visit and follow @HealioGastro on Twitter for the latest news emerging from #NASPGHAN2019.