January 25-26, 2018 Seda Vertis North, Quezon City - Hepatology ...
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January 25-26, 2018 Seda Vertis North, Quezon City
Vision
We are the lead national organization committed to the study of the liver in
health and disease, involved in research, education, advocacy and
formulation of national health Policies in partnership with the global
community.
Mission
❖ We shall provide and promote comprehensive information to the public
and to the medical community.
❖ We shall promote research to advance the field of hepatology to provide
relevant care to patients.
❖ We shall collaborate with the government in formulating in liver related
health policies.
❖ We shall share information, services and expertise with the global
community towards the prevention and treatment of liver diseases.
PAGES 4 Message from President Rodrigo “ROA” Duterte 5 Message from DOH Secretary 6 Message from the President of Hepatology Society of the Philippines 7 Message from the President of Philippine Society of Gastroenterology 8 Message from the President of Philippine Society of Digestive Endoscopy 9 Message from the Overall Chairman 10 Message from the Scientific Committee Chair 11 HSP Officers and Board of Directors 2017-2018 12-16 2018 HSP Convention Organizing Committee 17 Convention Venue Information 18-21 Detailed Scientific Program 22-28 Foreign Faculty 29-32 State of the Art Speakers 33-44 Local Faculty 45-52 Panelists 53-57 Session Chair and Co-Chair 58-61 Young Investigators Award Research Presentation 62-73 Abstracts 75-87 SPONSORS
My warmest greetings to the Hepatology Society of the Philippines as it holds
it 2018 Philippine Liver Meeting.
Today we recognize your feats and contributions towards the progress of this
community. By gathering leading local and international experts in this
meeting, you provide greater opportunities for growth among our medical
professionals. This would so enrich this highly specialized field and address
concerns related to the research, prevention and treatment of liver diseases.
Through years of change and development, remain to be at the forefront of the
education and empowerment of our physicians. May your endeavors to
advance the practice of hepatology strengthen the government’s resolve to
provide better medical care for our people. Together, let us raise the standard
of excellence as we formulate better health policies for our citizens.
I wish everyone a productive and meaningful event.
RODRIGO ROA DUTERTE MANILA
President of the Republic of the Philippines 25 January 2018
4
Dear Colleagues,
Mabuhay!
On behalf of the Hepatology Society of the Philippines, I would like to welcome you to
this year’s scientific convention, which we have named the Philippine Liver Meeting.
Upon perusal of the scientific program, I am certain that everyone will find that the
scientific content satisfies not only the specialists, but also generalists who see and
manage liver cases everyday in their clinics. It is our hope that the lectures, debates and
discussions in the meeting will not only satiate your hunger for knowledge, but also
stir up a desire in you to learn and discover more about the wonderful specialty of
Hepatology!
Finally, it has been said that a leader is only as good as the people that surround
him/her. I truly am blessed to be surrounded by very innovative, competent and
hardworking people led by Dr. Jade Jamias as the overall Chair of the meeting. His
term has truly done a wonderful job in organizing this meeting, which is already a
success story all its own.
So please sit back, relax, and learn.
Sincerely Yours
STEPHEN N. WONG, MD
President
Hepatology Society of the Philippines
5
Greetings!
On behalf of the Officers and Board of Directors of the Philippine Society of a
Gastroenterology and all its members, I would like to extend my
congratulations to the Hepatology Society of the Philippines for the much
anticipated 2018 Philippine Liver Meeting!
Managing liver disorders remain challenging and rewarding at the same time
and having a venue such as this to discuss, consult and collaborate is always
welcome.
The thought, consideration and care that went into the organization of this
meeting is undeniable and kudos to the Organizing Committee for all the hard
work and effort to promote Continuing Medical Education to all its members.
I look forward to seeing you all at the meeting!
JUDITH D. GAPASIN-TONGCO, MD
President
Philippine Society of Gastroenterology
6
Greetings!
On behalf of the Philippine Society of Digestive Endoscopy, I would like to
welcome you to the 2018 Philippine Liver Meeting. The PSDE fully supports
and endorses this scientific meeting. Spearheaded by the Hepatology Society
of the Philippines, this years event will touch on various liver diseases
ranging from NAFLD, hepatitis, cirrhosis and liver cancer. Expert faculties
both local and international will discuss updates in the diagnosis and
treatment of this conditions.
I hope we learn and apply the knowledge we get from this scientific meeting.
Ultimately this will be for the benefit of our patients who always rely on us
for updated information and guidance on their illness.
Thank you very much. See you there!
DENNIS A. ONA, MD, FPSG, FPSDE
President
Philippine Society of Digestive Endoscopy
7
Dear Colleagues,
Greetings!
This year marks the 12th year of the Hepatology Society of the Philippines (HSP) and as
we face and move forward to the coming years, we thought of creating a “signature
name” for our biennial scientific meeting, which is the PHILIPPINE LIVER
MEETING. This name will hopefully confer a distinct identity to our meeting similar to
our international counterparts.
The scientific committee headed by the very able, Dr. Janus Ong prepared a very
interesting and up to date topics which are not only relevant to liver specialists and
gastroenterologists but to the general practitioners as well. Apart from the usual didactic
lectures on various aspects of liver cirrhosis and liver diseases, there will be
multidisciplinary case discussions and debates on some of the controversial issues to
make the discussion more stimulating and attention-grabbing to our delegates. Rest
assured the next two days will be both enriching to our minds and entertaining to our
Ids.
On behalf of the organizing committee, it is my great honor and pleasure to welcome
you all to the 2018 Philippine Liver Meeting.
Let me end by saying, ” ANG HSP ANG TUNAY NA KAAGAPAY SA MGA
USAPING PATUNGKOL SA ATAY”.
Sincerely,
JADE D. JAMIAS, MD, FPCP, FPSG, FPSDE
Vice President, Hepatology Society of the Philippines
Overall Chairman, HSP 2018 Philippine Liver Meeting
8
Greetings!
On behalf of the scientific committee, I would like to invite you to join us at the
2018 Philippine Liver Meeting to be held on January 25-26, 2018 at the SEDA
Vertis North, Quezon City.
The Philippine Liver Meeting, organized by the Hepatology Society of the
Philippines, aims to present a comprehensive program that will cover the breadth
of Clinical Hepatology. The scientific committee has worked hard to come up
with a scientific program that is both timely and relevant to the care of patients
with liver disease in 2018.
International and local experts have been invited to tackle the latest advances in
the diagnosis and management of Nonalcoholic Fatty Liver Disease, Hepatitis B,
Hepatitis C, Hepatobiliary Malignancies, and the various complications of
cirrhosis such as coagulopathy, hepatopulmonary syndrome, and sarcopenia.
Aside from the traditional lecture format, there will be clinical debates on
controversial topics and multidisciplinary panel discussions on complex
hepatobiliary diseases.
I look forward to your active participation in the meeting. See you at the
Philippine Liver Meeting!
JANUS P. ONG, MD
Scientific Committee Head
HSP 2018 Philippine Liver Meeting
9
Stephen N. Wong, MD Jade D. Jamias, MD
President Vice President
Arlinking K. Ong-Go, MD Roberto N. De Guzman Jr., MD Jane Ricaforte-Campos, MD
Secretary Treasurer P.R.O.
Edhel S. Tripon, MD Angela D. SalvaÑa, MD Wendell Z. Espinosa, MD
Board Of Director Board Of Director Board of Director
Ian Homer Y. Cua, MD
Immediate Past President 1011
JADE D. JAMIAS, MD
Overall Chairman, HSP 2018 Organizing Committee
Vice President, Hepatology Society of the Philippines
12Janus P. Ong, MD
Head Committee
Joseph C. Bocobo, MD Eternity D. Labio, MD Edhel S. Tripon, MD Arlinking K. Ong-Go, Angelo B. Lozada, MD
MD
Roberto N. De Guzman Jr., Ruth Ursula C. Cinco, MD Eda Jo D. Amatong, MD
MD Head Comm. Member
Head Comm.
13Denis C. Ngo, MD Flor M. Maramag,
Head Comm. MD
Member
David M. Banayo, MD
Head Committee
MEMBERS:
Angela D. Salvaña,
MD
MEMBERS: Head Comm.
Conrado B. De Castro, MD Karl Yu Kim Teng, MD Christopher Sampana, MD
Eric Yasay, MD Marie Ellaine N. Velasquez, MD
14Edward L. Lim, MD
Head Comm.
Marilyn Talingdan-Te, MD
Head Comm.
Anne Marie Geraldine J. Javier, MD Don Izzy T. Yee, MD
MEMBERS: Head Committee Member
Milben A. Malbog, Shayne G. Villafuerte, MD
MD
15VENUE SEDA Vertis North, Quezon City
SPECIAL EVENTS
Opening Ceremony 25 Jan. 2018 10:15-10:45am Plenary
Fellowship Night 26 Jan. 2018 8:00pm Plenary
REGISTRATION
Registration counters are located at the 2nd Floor near stair way area and will be opened as follows:
* 25 Jan 2018 07:00-08:00 am
* 26 Jan 2018 07:00-08:00 am
BADGES All delegates are required to wear their name badges at all times during the convention.
CONVENTION EVALUATION SHEET will be submitted at the registration area.
All delegates are invited to visit the booths with interesting and relevant information on display. The booth for the gold
sponsors are located at the Foyer Area The rest of the booths are located at the Function Rooms.
LIABILITIES The Organizing Committee shall not be liable for personal accidents, loss or damage to private property
belonging to convention delegates during the convention. Delegates should make their own arrangements with respect to
personal insurance.
DISCLAIMER While every attempt would be made to ensure all aspects of the convention mentioned in the
announcement will take place as scheduled, the Organizing Committee reserves the right to make any last minute changes
should the needs arise without prior notice.
16TIME DAY 1 (Thursday) SPEAKER
07:00-08:00AM REGISTRATION
NAFLD
Chair: Jaime G. Ignacio, MD
Co-Chair: Wendell Z. Espinosa, MD
08:00-08:20AM Human Gut Microbiome: Its Implications in Liver Disease IAN HOMER Y. CUA, MD
08:20-08:40AM Lifestyle Modification in NAFLD: Practical Tips MICHAEL CHARLTON, MD
08:40-09:00AM NAFLD as a Systemic Disease: Its Implications on Management VINCENT WONG, MD
09:00-09:15AM OPEN FORUM
09:15-10:15AM MID-MORNING SYMPOSIUM ( MYLAN )
10:15-10:45AM OPENING CEREMONY
10:45-11:15AM STATE OF THE ART LECTURE I VINCENT WONG, MD
Treatment of Chronic Hepatitis B: Beyond Virologic Suppression
Chair: Judith Gapasin-Tongco, MD
11:15-11:45AM STATE OF THE ART LECTURE II REMIGIO M. OLVEDA, MD
Pathogenesis of Hepatosplenic and Subtle Morbidities in
Schistosomiasis japonica
Chair: Erlinda V. Valdellon, MD
11:45-1:15PM LUNCH SYMPOSIUM ( GETZ )
17TIME DAY 1 ( Thursday ) SPEAKER
VIRAL HEPATITIS
Chair: Leticia T. Ibañez-Guzman, MD
Co-Chair: Mark Anthony A. De Lusong, MD
1:15-1:35PM Isolated Anti-HBc: Implications for Liver Disease and Management DIANA A. PAYAWAL, MD
1:35-1:55PM WHO Guidelines on Hepatitis B and C testing: JOSE D. SOLLANO JR., MD
Distilling the Details for Local Use
1:55-2:15PM Antiviral Therapy In Difficult-To-Treat HCV Populations: Genotype 3, PROF. HAMID SAEED
Decompensated Cirrhosis, CKD, and Patients Eligible for Liver Transplant
2:15-2:30PM OPEN FORUM
2:30-2:45PM COFFEE BREAK/VISIT THE EXHIBIT
2:45-3:45PM MID-AFTERNOON SYMPOSIUM ( MENARINI )
3:45-4:15PM Debate: Locally Advanced HCC (BCLC C with PVT and no extra hepatic STEPHEN N. WONG, MD
mets): Locoregional Therapy or Sorafenib? JENNY L. LIMQUIACO, MD
Chair: Evelyn B. Dy, MD
Co-Chair: Dennis A. Ona, MD
Moderator: JANUS P. ONG,
MD
Management of AOCLF In The ICU: Discussants:
4:15-5:15PM A Multidisciplinary Discussion Eternity D. Labio, MD
Emily Aventura, MD
Roberto Tanchanco, MD
Vanessa De Villa, MD
Cybelle Abad, MD
5:15-6:45PM SUNSET SYMPOSIUM ( HI-EISAI ) 18TIME DAY 2 ( Friday ) SPEAKER
07:00-08:00AM REGISTRATION
CIRRHOSIS
Chair: Ernesto G. Olympia, MD
Co-Chair: Estrellita J. Ruiz, MD
08:00-08:20AM The Rational Use of Albumin in Cirrhosis ANGELA D. SALVAÑA,
MD
08:20-08:40AM Cardiac and Pulmonary Complications of Cirrhosis: Recognition and EDHEL S. TRIPON, MD
Management
08:40-09:00AM Sarcopenia in Cirrhosis: Causes, Implications and Management JADE D. JAMIAS, MD
09:00-09:20AM Coagulopathy in Liver Disease – Monitoring, Therapies and Indications for TERESITA E. DUMAGAY,
Blood Products MD
09:20-9:35AM OPEN FORUM
9:35-10:35AM MID-MORNING SYMPOSIUM ( SIRTEX )
10:35-10:50AM COFFEE BREAK / VISIT EXHIBIT
10:50-11:20AM STATE OF THE ART LECTURE III FRANCIS ESCUETA
Current Status Of Organ Donation In the Philippines SARMIENTO III, MD
Chair: Dina C. Gonzales, MD
11:20-12:50PM LUNCH SYMPOSIUM ( BAYER )
19TIME DAY 2 ( Friday ) SPEAKER
HEPATOBILIARY MALIGNANCY
Chair: Marichona C. Naval, MD
Co-Chair: Albert E. Ismael, MD
12:50-1:10PM Combined Hepatocellular - Cholangiocarcinoma: Recognition, YI-HSIANG HUANG, MD, PhD
Diagnosis and Management
1:10-1:30PM The Emerging Conundrum of Hepatocellular Carcinoma and DAA PROF. JIA-HORNG KAO
Therapy for HCV
1:30-1:50PM Treatment of Intermediate HCC (BCLC B): PROF. STEPHEN LAM CHAM
Surgery, Locoregional Therapy, or Systemic Thearpy
1:50-2:05PM OPEN FORUM
2:05-3:05PM MID-AFTERNOON SYMPOSIUM ( KAUFMANN )
3:05-3:50PM RESEARCH SYMPOSIUM
3:50-4:05PM COFFEE BREAK/VISIT EXHIBIT
4:05-4:35PM Debate-Non-Neoplastic Protal Vein Thrombosis in Cirrhosis: JUDY Y. LAO-TAN, MD
Anticoagulate or not? MARILYN O. ARGUILLAS, MD
Chair: Frederick T. Dy, MD
Co-Chair: Marie Michelle S. Cloa, MD
4:35-5:35PM The Patient With A Hilar Mass: A Multidisciplinary Discussion Moderator:
ARLINKING K. ONG-GO, MD
Discussants:
Evan G. Ong, MD, Billy Uy, MD
Denky Dela Rosa, MD
Roy Habito, MD
5:35-7:05PM SUNSET SYMPOSIUM ( INNOGEN )
7:05PM FELLOWSHIP NIGHT 2021
Medical School: Charing Cross and Westminster Medical
School, University of London, England
Training: Residency, Internal Medicine,
Fellowship, Gastroenterology and Hepatology
University of Vermont, Burlington, Vermont
Fellowship Hepatology and Liver Transplant,
Mayo Clinic
Board Certified in Internal Medicine, Gastroenterology and Hepatology, and
Transplant Hepatology
Professor of Medicine, Director Transplant Institute and Center for Liver
Diseases, University of Chicago Biological Sciences
Associate Editor, American Journal of Transplantation
Research Interests include Transplant Immunosuppression, Hepatitis C,
Metabolic Diseases, NAFLD
22Medical School: The Chinese University of Hong Kong
Training: Residency in Internal Medicine,
Fellowship in Gastroenterology and Hepatology,
The Chinese University of Hong Kong
Professor, Department of Medicine and Therapeutics,
The Chinese University of Hong Kong
Former President (2015-2017), Hong Kong Association Study for Liver
Diseases
Associate Editor, Clinical Gastroenterology and Hepatology
Research Interests include Viral Hepatitis, Non-Alcoholic Fatty Diseases
23Medical School College of Medicine, National Yang-Ming University,
Taipei, Taiwan
Training Postdoctoral Fellow, Vaccine Branch, National
Cancer Institute, National Institute of Health,
Bethesda, MD, USA
Chief, Division of Gastroenterology & Hepatology, Department of Medicine,
Taipei Veterans, General Hospital, Taipei, Taiwan
Director, Department of Internal Medicine, Faculty of Medicine, National
Yang-Ming University School of Medicine, Taipei, Taiwan
Professor Institute of Clinical Medicine, National Yang-Ming University
School of Medicine, Taipei, Taiwan
Editorial Board, PLoS One, Liver International, Advances Indigestive Medicine
24Medical School King Edward Medical College, Lahore
Training Clinical Research Fellow, Gastroenterology, John
Radcliff Hospital, University of Oxford, Oxford UK
Fellowship Hepatology, Liver Unit, South Western Medical
School, University Texas, Dallas
The Ibn-e-Sina Chair and Professor Consultant Gastroenterologist,
Department of Medicine, The Agkhan University and Hospital, Karachi,
Pakistan
Editorial Board, Hepatology International, World Journal of
Gastroenterology, Journal Gastroenterology and Hepatology and
many others
25Medical School College of Medicine, National Taiwan
University, Taiwan
Training Residency in Internal Medicine, National
Taiwan Hospital
Fellowship in Gastroenterology and
Hepatology, Taiwan University Hospital
National Chair Professor, Ministry Education, Taiwan
Distinguished Professor at the Graduate Institute of Clinical
Medicine, College of Medicine, National Taiwan University
Hospital
Director Division of Hepatology and Gastroenterology, National
Taiwan University Hospital
President Taiwan Association for the Study of the Liver
Fellow American Association for the Study of the Liver
Diseases
Editor in Chief, Journal of Formosan Medical Association
26Medical School The Chinese University of Hong Kong
Associate Professor, Department of Clinical Oncology, The Chinese
University of Hong Kong
International Member, National Cancer Institute (NCI)
Hepatobilliary Task Force
Editorial Board, Liver International and Asia-Pacific Journal of
Clinical Oncology
Gold Medal for Dissertation (2007) and Young Investigator Award
(2008) from Hong Kong College of Physicians
Research Interest include Clinical and Translation Research in
Hepatocellular Carcinoma
2728
Medical School: The Chinese University of Hong Kong
Training: Residency in Internal Medicine,
Fellowship in Gastroenterology and
Hepatology, The Chinese University of
Hong Kong
Professor, Department of Medicine and Therapeutics,
The Chinese University of Hong Kong
Former President (2015-2017), Hong Kong Association Study for
Liver Diseases
Associate Editor, Clinical Gastroenterology and Hepatology
Research Interests include Viral Hepatitis, Non-Alcoholic Fatty
Diseases
29Diplomate in Internal Medicine and a Fellow of the Philippine College of
Physicians and Philippine Society of Gastroenterology.
Director, Research Institute for Tropical Medicine, Department of Health,
Philippines, 1993 to 2013.
Member, National Academy of Science and Technology
Pioneering work in Schistosomiasis research
• Worked simultaneously in both basic science laboratory research, field
research, and translational research in the study of Schistosoma
japonicum
• First to use portable ultrasound to define liver pathology induced by
Schistosoma japonicum
• Early investigator in the field of “Subtle Morbidity,” which changed the
approach to schistosomiasis control from treating only heavy infected
individuals to population-based mass chemotherapy
• First to show the impact of Schistosomiasis on growing children during
the adolescent growth spurt as well as the impact of the Far Eastern strain
of schistosomiasis on anemia
• Collective work has been critical to the worldwide schistosomiasis
control efforts and has guided the Schistosomiasis Control Program in the
Philippines for decades.
30Medical School, College of Medicine, University of the Philippines,
Manila
Recipient, Certificate on the Gender, Reproductive Health and Fertility module
under The Amsterdam Masters in Medical Anthropology from the Universiteit van
Amsterdam in The Netherlands.
Programme Manager, United Nations Development Program's International Open
Source Network for the ASEAN, 2006 to 2009
Executive Assistant, Office of the President and CEO, Philhealth, 2011 to 2015
Completed Transplant Procurement Management-Advanced International
Training Course in Transplant Coordination
Presently, Program Manager, Philippine Network for Organ Sharing (PhilNOS)
and Philippine Organ Donation and Transplantation Program (PODTP)
Dr. Sarmiento is pursuing his master's degree in Health Informatics (Medical
Informatics track) at the University of the Philippines in Manila.
3132
Training Internal Medicine Residency at St. Luke’s
Medical Center Quezon City
Gastroenterology Fellowship at St. Luke’s
Medical Center Quezon City
Post-fellowship training in:
* Hepatology at Storr Liver Unit, Westmead
Millenium Institute, University of Sydney
at Westmead Hospital
*Interventional Hepatology at Chang Gung
Memorial Hospital, Linkou, Taiwan;
*Transplantation Hepatology at the Center for
Liver Disease and Transplantation, New York
Presbyterian Hospital, Columbia University,
Medical Center, USA
Immediate Past President, Hepatology Society of the
Philippines
Assistant Head of the St. Luke’s Liver Disease and Transplant
Center-Bonifacio Global City
33Medical School Faculty of Medicine and Surgery of the
University of Sto. Tomas
Training Gastroenterology and Digestive Endoscopy,
University of Sto. Tomas
Hepatology, Interventional Sonology and
Digestive Endoscopy
University of Tokyo
Clinical Associate Professor of the Department of Medicine,
University of Sto. Tomas
Past President of Philippine Society of Gastroenterology and
Hepatology Society of the Philippines
Board Regent, Philippine College of Physicians
34Medical School University of Santo Tomas
Training Gastroenterology Fellowship from the
University of Santo Tomas Hospital
Professor of Medicine, University of Santo Tomas College of
Medicine & Surgery
Past President of the Philippine Society of Gastroenterology,
Digestive Endoscopy, Hepatology Society of the Philippines,
Philippine College of Physicians and Asia Pacific
Association for the Study of the Liver (APASL)
Member, Chronic Hepatitis B Global Guidelines Task Force of
the World Gastroenterology Organization (WGO)
35Medical School University of Santo Tomas, Bachelor
of Science Major in Biology “Accelerated
program “ 1991-93, Doctor of Medicine
1994-97 Graduated “cum laude”
Training Internal Medicine, University of
Santo Tomas
Fellowship in Gastroenterology,
University of Michigan (Ann Arbor,
MI USA) Clinical Hepatology,
Chang Gung Memorial Hospital
(Linkou, Taiwan R.O.C.)
Fellowship in Interventional
Hepatology (Radio frequency
ablation & Ethanol injection of liver
tumors)
President, Hepatology Society of the Philippines
36Medical School Cebu Institute of Medicine
Training Internal Medicine at Chong Hua Hospital,
Cebu
Gastroenterology Fellowship at
Philippine General Hospital
Clinical Hepatology at Prince of Wales
Hospital HK
RFA/Interventional Hepatology at Chang
Gung Memorial Hospital, Taiwan
Assistant Professor IV – Cebu Institute of Medicine
Clinical Tutor – Cebu Doctors University Hospital
Section HEAD of Gastroenterology and Endoscopy, University of
Cebu Medical Center and St Vincent General Hospital
Member, Hepatology Society of the Philippines
37Medical School University of the Philippines,
College of Medicine
Training Internal Medicine Residency
Medical College of Wisconsin
Gastroenterology Fellowship at the
Philippine General Hospital
Hepatology Fellowship at
University Hospitals of Cleveland
Clinical Associate Professor at the UP College of Medicine
Board Member, Hepatology Society of the Philippines
Member, Philippine Society of Gastroenterology abd Philippine
Society of Digestive Endoscopy
38Medical School University of the Philippines College
of Medicine
Training Internal Medicine, University of the
Philippines-Philippine General
Hospital
Fellowship Gastroenterology and
Digestive Endoscopy, University of
the Philippines-Philippine General
Hospital
Clinical fellowship in Hepatology,
National University Hospital
Singapore
Medical Specialist, Bulacan Provincial Hospital
Board Member, Hepatology Society of the Philippines
39Medical School University of Sto. Tomas, Faculty
of Medicine and Surgery
Training Gastroenterology and Digestive
Endoscopy at the UP-PGH
General Hepatology and Liver Transplant
Medicine at the AW Morrow
Gastroenterology and Liver Centre in
Sydney, Australia
Past Training Officer, Department of Internal Medicine at the
National Kidney and Transplant Institute
Vice President, Hepatology Society of the Philippines
40Training Internal Medicine, UP-PGH
Fellowship Training in Adult Hematology,
UP-PGH, (Chief Fellow)
Observership in Blood and Marrow
Transplantation
Kelo University Hospital,
Institute of Medical Sciences University
of Tokyo,
National Cancer Center, Hospital Tokyo
Affiliations/Appointments:
* Fellow of the Philippine College of Physicians
* Diplomate of the Philippine Society of Hematology
and Blood Transfusion
* Member, Philippine Society of Blood and Marrow
Transplantation
Member, Philippine Medical Association
Presently, Associate Clinical Professor, UP PGH,
Active Consultant, Medical Center Manila,
Active Consultant, Manila Doctors Hospital
41Medical School Cebu Institute of Medicine
Training Fellowship in Gastroenterology at the UP
Philippine General Hospital
Earned Master of Arts in Teaching Related
Sciences from the Cebu Doctors Hospital
Founding member, Hepatology Society of the Philippines
Past Chairperson of the Department of Medicine at the Chong Hua
Hospital
Served as Member of the Board of Directors of the Philippine
Society of Gastroenterology and Hepatology Society of the
Philippines
42Medical School University of the Philippines,
College of Medicine
Training Fellowship in Gastroenterology at
the UP- Philippine General Hospital
Served as a member of the Board of Directors of the Philippine Society
of Gastroenterology and the Hepatology Society of the Philippines
Past President of the Hepatology Society of the Philippines
Past Exec. Council, Asian Pacific Association for the Study of the
Liver (APASL)
4344
45
Eternity D. Labio, MD
Roberto Tanchanco, MD
Vanessa H. De Villa, MD
Emily Aventura, MD Cybele Abad, MD
46Medical School University of the Philippines, College of
Medicine
Training Fellowship, Gastroenterology at the UP-
Philippine General Hospital
Fellowship, Hepatology and Liver
Transplantation at the Royal Prince Alfred
Hospital, University of Sydney, Australia
Past President, Hepatology Society of the Philippines (HSP)
Active Consultant, Medical City, Asian Hospital and Makati Medical
Center
47Medical School University of the Philippines, College of
Medicine
Training Doctoral Studies at the Faculty of
Medicine, University of Navarre, Spain
Fellowship, Liver Surgery and Liver
Transplantation at Chang Gung Memorial
Hospital in Kaohsiung, Taiwan
Worked with the Hepatobiliary and Liver Transplantation Division of
the Department of Surgery of the University of Hong Kong, Queen
Mary Hospital
Fellow of the Philippine College of Surgeons, the Philippine Society
for Transplant Surgeons
Chair of the Philippine Board of Transplant Surgery
Director of the Center for Liver Disease Management and
Transplantation at The Medical City
Member, Hepatology Society of the Philippines
48Medical School : University of the East Ramon Magsaysay Memorial Medical
Center
Training: Residency in Internal Medicine, Philippine General
Hospital
Fellowship in Nephrology, Philippine General
Hospital
International Fellowship in Nephrology, Cleveland
Clinic in Ohio, USA
Masters in Business Administration, Ateneo Graduate
School of Business
Affiliations:
Fellow, Philippine College of Physicians
Fellow, Philippine Society of Nephrology
Presently,
\ President, Philippine Society of Nephrology
Head, Section of Nephrology of the Department of Medicine The Medical
City
Consultant Director of the Transplantation Program The Medical City 49Medical School: University of Sto. Tomas, Manila Philippines
Training:
Internal Medicine, Louisiana State University Health Sciences Center
New Orleans, Louisiana
Fellowship, Pulmonary Critical Care Medicine
Louisiana State University Health Sciences Center/
Ochsner, Clinic Foundation, New Orleans, Louisiana
Affiliations:
Philippine College of Chest Physicians
Diplomate, American Board of Internal Medicine Critical Care
Certification
Diplomate, American Board of Internal Medicine Pulmonary Disease
Certification
50Medical School: University of the Philippines College of Medicine
Training:
Residency in Internal Medicine, Rush University Medical Center
Chicago, Illinois USA
Fellowship in Infectious Disease
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin USA
Transplant Infectious Disease
Mayo Clinic Rochester, Minnesota
Affiliations:
Fellow, Philippine College of Physicians
Fellow, Infectious Disease Society of America
Member, American College of Physicians
Member, Society for Healthcare Epidemiology of America
Presently,
Chair, Infection Control Committee
The Medical City
5152
Evan G. Ong, MD Denky Shoji Dela Rosa, MD
Roy Habito, MD
Billy James Uy, MD
53Medical School University of the East Ramon Magsaysay
Memorial Medical Center
Training Residency in Internal Medicine
University of the East Ramon Magsaysay
Memorial Medical Center
Oncology Fellowship training at Philippine
General Hospital
Associate Professor at University of the East Ramon Magsaysay
Memorial Medical Center
Affiliated with St. Luke’s Medical Center Bonifacio Global City
54Medical School: University of Santo Tomas College of Medicine
Training:
Fellowship, Gastroenterology
University of Santo Tomas College of Medicine
Fellowship, Advanced Therapeutic Endoscopy, Department of
Endoscopic Surgery,
University of Hamburg
Past President, Philippine Society of Digestive Endoscopy
Current Appointment:
Section Head of Gastroenterology, Metropolitan Hospital
55Medical School: Doctor of Medicine, Magna Cum Laude
University of Santo Tomas
Training: Residency in General Surgery
Chinese General Hospital and Medical Center
Fellowship in Hepato-Biliary and PancreaticSurgery
Seoul National University Bundang Hospital, South Korea
Affiliations: Fellow, Philippine College of Surgeons
Fellow, Philippine Society of General Surgeons
Fellow, Philippine Association of Laparoscopic and
Endoscopic Surgeons
Fellow, Philippine Association of Hepato- Pancreato- Biliary
Surgery
Academic Appointment:
Assistant Professor II, Department of Physiology
Manila Central University- Filemon D. Tanchoco Medical
Foundation
56Medical School: University of the Philippines College of Medicine
Training:
Residency in Diagnostic Radiology
University of the Philippines- Philippine General Hospital
Clinical Fellow, Vascular and Interventional Radiology, Nuclear
Medicine and Molecular Imaging, Abdominal Imaging and Interventional
Radiology
Massachusetts General Hospital/Harvard Medical School
Current Appointments:
Chairman, Department of Radiology
The Medical City, South Luzon
Technical Consultant, Center for Device Regulation, Radiation
Health and Research, Food and Drug Administration, Department of
Health, Philippines
2016 Balik Scientist Awardee, Department of Science and
Technology, Philippines
Associate Editor, Frontiers in Oncology, Lausanne, Switzerland 5758
Jaime G. Ignacio, MD Leticia T. Ibañez-Guzman, MD
Chair Chair
Wendell Z. Espinosa, MD Mark Anthony A. De Lusong, MD
Co-Chair Co-Chair
59Erlinda V. Valdellon, MD
State of the Art Chair
Judith D. Gapasin-Tongco, MD Dina C. Gonzales, MD
State of the Art Chair State of the Art Chair
60Evelyn B. Dy, MD Frederick T. Dy, MD
Chair Chair
Co-Chair
Dennis A. Ona, MD Marie Michelle S. Cloa, MD
Co-Chair Co-Chair 61Ernesto G. Olympia, MD Marichona C. Naval, MD
Chair Chair
Estrellita J. Ruiz, MD Albert E. Ismael, MD
Co-Chair Co-Chair
6263
Prevalence of NAFLD Among Patients with Pre-diabetes Mellitus at the
Out-patient Clinics
64Predictors for Refractoriness to Transarterial Chemoembolization Among
Hepatocellular Caner Patients. A Ten Year Single Center Study
65Radiofrequency Ablation of Liver Metastasis from Colorectal Cancer with
or without Chemotherapy Leads to Better
6667
Human Gut Microbiome: Its Implication in Liver Disease
Ian Homer Y. Cua, MD
Gut microbiota changes are important in determining the occurrence and
progression of chronic liver disease related to alcohol, nonalcoholic fatty liver
disease, and cirrhosis. Specifically, the systemic inflammation, endotoxemia, and
the vasodilation that leads to complications such as spontaneous bacterial
peritonitis and hepatic encephalopathy could be related to the gut milieu. Given the
poor prognosis of these events, their prevention and early management are
essential. Microbiota may be an essential component of the gut milieu that can
impact these clinical events. Recent human and animal studies have shown that the
relative abundance and the functional changes of microbiota in the stool, colonic
mucosa, and saliva have varying consequences on the presence and prognosis of
chronic liver disease and cirrhosis. The impact of therapies on the microbiota is
slowly being understood and will likely lead to a more targeted approach to gut
microbiota modification in chronic liver disease and cirrhosis.
68NAFLD as a systemic disease: Its implications on management
Prof. Vincent Wong
Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease
worldwide, affecting a quarter of the Asian adult population. In Western countries, NAFLD, especially
nonalcoholic steatohepatitis (NASH), has already become one of the leading causes of end-stage liver
disease and hepatocellular carcinoma.
It is well recognized that NAFLD is strongly associated with all components of the metabolic
syndrome. In particular, even among patients with normal fasting blood glucose, postprandial
hyperglycemia is common, and insulin resistance is almost universal. The diagnosis of NAFLD may
also predates the diagnosis of diabetes for several years. Along the same line, cardiovascular
disease, chronic kidney disease and extrahepatic malignancies have all been reported to be more
common among NAFLD patients. The association is even stronger in patients with NASH or advanced
fibrosis.
Nonetheless, it is important to highlight that association is not the same as causation. With a few
exceptions, NAFLD has not been proven to be the cause of the systemic disorders. While lifestyle
modification is expected to benefit both NAFLD and the other metabolic disorders, it is unclear if a
NASH-specific treatment (4 drugs have entered phase 3 development) will impact on the associated
disorders. In any case, since the association between NAFLD and metabolic diseases and
complications is strong, hepatologists should recognize NAFLD as a systemic disease and provide
optimal care for the metabolic diseases. In addition, colorectal cancer screening should be
recommended because it is one of the obesity-related cancers and screening has been shown to save
lives.
69Treatment of Chronic Hepatitis B: Beyond Virologic Suppression
Prof. Vincent Wong
Chronic hepatitis B affects around 248 million individuals globally and is the leading cause of
end-stage liver disease and hepatocellular carcinoma in most Asian countries. The development
of oral nucleos(t)ide analogs (NAs) in the late 1990s has revolutionized the management of
chronic hepatitis B. Currently, the use of entecavir and tenofovir disoproxil fumarate (TDF) can
lead to hepatitis B virus (HBV) DNA suppression, alanine aminotransferase normalization,
hepatitis B e antigen seroconversion (HBeAg) and histological improvement with a low risk of
drug resistance.
Nevertheless, because NAs suppress but do not eliminate HBV, many patients require long-term
treatment. According to current guidelines, HBeAg-positive patients may stop NAs after
sustained HBeAg seroconversion and HBV DNA suppression. The optimal management for
HBeAg-negative patients with complete viral suppression by NAs is elusive. While virologic
relapse is very common after treatment cessation, some small case series suggest that such
relapse may be followed by hepatitis B surface antigen (HBsAg) seroclearance in some patients.
As the current NAs are already very good at suppressing HBV, our next goal should be function
cure as represented by HBsAg seroclearance. Peginterferon alfa-2a is another treatment option
for chronic hepatitis B. Compared with NAs, peginterferon can clear intrahepatic covalently
closed circular DNA (cccDNA). Peginterferon-induced HBeAg and HBsAg seroclearance is also
more durable. A few groups have tried to add peginterferon in patients with HBV DNA suppressed
by NAs with varying success. Even so, it is unlikely that peginterferon treatment with and without
NAs can result in HBsAg seroclearance in more than 20% of patients.
70Treatment of Chronic Hepatitis B: Beyond Virologic Suppression
Prof. Vincent Wong
A number of new agents have now entered phase 1 to 2 development with the aim of
achieving HBsAg seroclearance or at least durable off-treatment response. The new
treatments can be broadly divided into direct-acting antivirals and host-targeting
agents. Early studies on capsid inhibitors and small interfering RNA have already
shown some effects on HBV DNA and HBsAg levels. Data on more meaningful
endpoints and durability are eagerly awaited.
71State of the Art Lecture: Pathogenesis of Hepatosplenic and
Subtle Morbidities in Schistosomiasis japonica and mansoni
Remigio M. Olveda, MD, FPCP, FPSG
Morbidities in schistosomiasis are grouped into those with clear end-organ complications and those
with subtle manifestations. In the hepatosplenic form of schistosomiasis japonica and mansoni, lesions
around the eggs trapped in the pre-sinusoidal areas of the liver start as eosinophilic infiltrates around
the ova. A granuloma eventually develops around the ova and over time, the ova inside degenerate and
calcify. Eventually, granulomas are replaced by surrounding fibrous tissue formation. The mechanisms
involve in granuloma formation and fibrosis in the liver have been documented extensively. Th1 cells
response predominate in the early phase followed by Th2 cells response in the late stage of the
granuloma formation. Towards the end stage of granuloma formation, the fibroblasts are stimulated by
egg products and by T lymphocyte cytokines to proliferate, replace most of the cellular elements, and
mediate fibrotic collagenous material deposition around the portal vein tributaries. Severe fibrosis
causes portal vein obliteration leading to the development of portal hypertension and lethal
complications. On the other hand, inflammatory cytokines induced by eggs or worm products are
responsible for the pathogenesis of subtle morbidities like growth retardation, malnutrition and
impaired cognitive functions in children and poor pregnancy outcomes. Production of inflammatory
cytokines such as TNF-, IL-6, and IFN- have been suggested as the basis through which S. japonicum
may lead to poor linear growth and under-nutrition. For adverse birth outcomes associated with
maternal schistosomiasis direct infection of the placenta or female reproductive tract is not the primary
mechanism involve but more by systemic effects of infection mediate both by extra-placental and
placental processes. The mechanisms involve in the development of schistosome induced anemia are 4
not 2. They are: (1) iron deficiency due to extra-corporeal loss; (2) splenic sequestration; (3)
autoimmune hemolysis; and (4) anemia of inflammation.
72The Rational Use of Albumin in Cirrhosis
Angela D. Salvaña, MD
Human serum albumin undergoes quantitative, structural and functional
changes in cirrhosis, affecting common clinical complications of
cirrhosis. This session discusses the changes in albumin associated
with ascites, hepatorenal syndrome and septic shock in cirrhosis.
Practical pointers for use of albumin will also be discussed.
73Cardiac and Pulmonary Complications of Cirrhosis
Edhel S. Tripon MD
Cirrhotic patients may undergo important changes in their cardiovascular and pulmonary
physiology in the setting of portal hypertension. These changes may lead to deterioration in the
quality of life and increased morbidity and mortality pre and post liver transplant. Cirrhotic
cardiomyopathy is a well described condition that is not often diagnosed, especially in its early
stages when resting cardiac function may appear normal. It is characterized initially by
hyperdynamic circulation, diastolic dysfunction, electrophysiologic changes and later on
systolic dysfunction and possibly outright cardiac failure symptoms. Three unique pulmonary
conditions in portal hypertension include hepatic hydrothorax, hepatopulmonary syndrome and
portopulmonary syndrome. Hepatic hydrothorax is a transudative pleural effusion in the context
of cirrhosis and/or portal hypertension in the absence of significant cardiac, pulmonary and
pleural disease. It is important to recognize hepatic hydrothorax and its complication,
spontaneous bacterial pleuritis ( also called spontaneous bacterial empyema). Management of
this unique effusion is similar to the stepwise management of ascites in portal hypertension and
chest tube drainage is avoided. The two main conditions that may be affected by changes in
pulmonary vasculature are hepatopulmonary syndrome and portopulmonary hypertension. The
diagnosis of either condition impacts survival and may have major clinical implications if liver
transplant is being considered.
74SARCOPENIA IN CIRRHOSIS: Causes, Implications and Management
Jade D. Jamias, MD, FPCP, FPSG, FPSDE
Objectives:
1. To define the meaning of sarcopenia with particular reference to cirrhotic patients.
2. To discuss the impact of sarcopenia on morbidity and mortality in cirrhosis (including its
impact on post-transplant outcomes).
3. Introduce the methods that may be used to diagnose and assess sarcopenia in cirrhosis.
4. Evaluate the role of nutrition, dietary supplementation and exercise on the management of
sarcopenia in cirrhosis.
5. Discuss in brief Sarcopenic Obesity in CLD, NAFLD with NASH – how to recognize it and
management approaches.
Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle
mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life
and, ultimately, death. The most typical symptom of sarcopenia is muscle wasting, defined as a
progressive and generalized loss of muscle muscle mass. For the diagnosis of sarcopenia, the
European Working Group on Sarcopenia in Older People recommends using the presence of both
low muscle mass and reduced muscle function (strength or performance).
The pathogenesis of sarcopenia in cirrhosis has three (3) major contributory causes: inadequate
dietary intake, metabolic disturbance and malabsorption.
Several studies have shown that sarcopenia negatively impacts on the quality of life (QoL), survival
and the development of complications in cirrhosis. It likewise adversely impacts outcomes in
patients on the transplant list, in the peri-transplant period and post-transplantation.
75SARCOPENIA IN CIRRHOSIS: Causes, Implications and Management
Jade D. Jamias, MD, FPCP, FPSG, FPSDE
Numerous indirect methods have been used to quantify body composition in cirrhotics but most
lack either availability and/or reproducibility and their their accuracy is limited in the presence of
fluid retention. Cross sectional imaging studies, including CT scan or MRI are the gold standard
tools to quantify skeletal muscle mass and hence constitute a good tool for objective nutritional
and metabolic assessment of cirrhotic patients and identification of sarcopenia.
Therapeutic options for sarcopenia in cirrhosis are as follows: 1. increased protein intake, late-
evening snacks, repeated snacks, branched-chain amino acids (BCAAs) and protein
supplementation, 2. Exercise, both aerobic and resistance physical activity, 3. Transjugular
intrahepatic portosystemic shunt (TIPS). Therapies targeting mitochondrial function including
mitochondrial antioxidants, m-TOR signaling and myostatin, hold promise for the future.
The current global obesity epidemic has created a new condition: the combination of sarcopenia
and obesity, described as Sarcopenic Obesity. Obesity is frequently accompanied by NAFLD and it
can progress to NASH and liver cirrhosis. Given the increasing prevalence of NAFLD globally,
sarcopenic obesity will likely to be a major condition in cirrhotic patients in the future.
76Coagulopathy in Liver Disease - Monitoring, Therapies and
Indications for Blood Products
Teresita Dumagay, MD
Hemostasis among patients with cirrhosis presents its own set of challenges
even amongst the most experienced physicians. While there are guidelines and
recommendations in existence to help manage our patients, it is in individualizing
management strategies in patient care that physicians encounter dilemmas. This
session is intended to provide an avenue to clarify some such dilemmas.
Specifically, this session aims to review the different aspects of coagulopathy in
cirrhosis, discuss often encountered clinical dilemmas in patients with cirrhosis
specifically patients who have abnormal bleeding parameters, discuss rational
monitoring for coagulopathy in cirrhosis peri-procedure, and discuss indications and
thresholds for rational blood product transfusion in cirrhosis.
This session will be case based in format with common clinical cases used as
jump off scenarios in the discussion of each of the objectives.
77Combined Hepatocellular-Cholangiocarcinoma: Recognition,
Diagnosis and Management
Yi-Hsiang Huang, MD, Ph.D.
Combined Hepatocellular-Cholangiocarcinoma (cHCC-CC) is a rare and distinct subtype of liver
malignancy, accounting for 1% to 14.2% of HCC cases. The features and clinical behavior of
cHCC-CC remain ill-defined. The radiological characteristics of cHCC-CC are varied. On contrast-
enhanced CT a variable pattern of enhancement has been described. Most of the cases have
atypical radiological pattern for HCC in CT scan. Different histologic subtypes of CC have been
shown to have varying enhancement patterns. The diagnosis of cHCC-CC relies on pathological
findings, and it remains a challenging diagnosis prior to resection. According to the 2010 World
Health Organization (WHO) classification, cHCC-CC can be divided into two main categories
based on pathological features: the ‘classical’ type and the ‘stem-cell features’ type. The latter of
which is extremely rare and can be further subclassified into three subtypes: typical,
intermediate and cholangiolocellular carcinoma. Current clinical practice guidelines do not
provide a specific treatment recommendation for cHCC-CC, and surgical resection remains the
only chance of cure, when feasible. The outcome of cHCC-CC is considered to be worse than
HCC alone, however the data were not consistent throughout the reports because of small case
number in different series. In a series of 53 patients with cHCC-CC underwent tumor resection,
the 1-, 3-, and 5-, tumor recurrence rates were 60.8, 71.8, and 80.7, respectively. The 1-, 3-, and 5-
overall survival rates were 73.3, 35.6, and 30.5, respectively. Liver transplantation may not be
considered as a high recurrence rate can be expected. The role of chemotherapy or targeted
therapy with sorafenib for cHCC-CC is still unclear. In conclusion, cHCC-CC is a rare disease
entity, no clear treatment paradigm has yet been defined. Currently, surgery remains the only
effective treatment option.
78The Emerging Conundrum of Hepatocellular Carcinoma Recurrence
and DAA Therapy for HCV
Jia-Horng Kao MD, PhD, FAASLD
HCV infection is the leading cause of hepatocellular carcinoma (HCC) worldwide. Compared to HCV
patients who fail to achieve sustained virological response (SVR) following interferon (IFN)-based antiviral
therapies, those who achieve SVR have decreased long-term morbidity and mortality. In recent years,
treating HCV with IFN-free direct acting antiviral agents (DAAs) has shown superb efficacy and safety and
thus becomes the current standard of care for HCV infection. In 2016, Reig et al. reported an alarmingly
high rate of early HCC recurrence (28%) after DAA therapies among HCV patients who received curative
HCC treatment. Afterwards a serious concern about the benefits of DAA therapy in such patients was
raised. In contrast, subsequent studies from different parts of the world consistently showed that among
patients with DAA therapy, SVR was associated with a considerable reduction in HCC risk. There was no
evidence to suggest that DAAs promote HCC. Nevertheless, in patients with SVR, the absolute risk of HCC
remained high in patients with established liver cirrhosis, indicating these patients should receive ongoing
HCC surveillance. In a recent meta-analysis on 41 studies, meta-regression adjusting for follow-up period
and age showed that DAA therapy was not associated with higher HCC occurrence (RR 0.68; p=0.55) or
recurrence (RR 0.62, p=0.56). Therefore, there is no evidence for differential HCC occurrence or recurrence
risk following SVR from DAA and IFN-based therapy. In conclusion, the link between HCC occurrence or
recurrence and IFN-free DAA therapy has not been confirmed, more robust data such as randomized
controlled trials are urgently awaited to examine this interesting and important issue.
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In cooperation with
February 16, 2018 (Friday)
8:00 AM to 5:00 PM
SEDA Hotel, Davao City
HSP CPD – 5.75 Units PCP CPD - 2 Units PCOM CME – 5.5 Units PMA CME - 40 Units PAFP CPD– 5 Category II
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