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2016 Annual Minutes 0 J. Douketis Working Group for Perioperative Thrombosis and Hemostasis Public Session, May 25, 2:15-6:15PM, Salle Foche 5, Montpellier, France Working Group Chairman: James Douketis  This session, organized by the Working Group on Perioperative Thrombosis and Haemostasis, was held in a 200-person room. Attendance was recorded at 240 people, with need to use the overflow room to accommodate extra attendees. The presenters represented a spectrum of medical specialists, including internists, hematologists, intesivists and anesthetists, reflecting the multidisciplinary nature of the working group. The session was commenced by an abstract presentation on Thromboelastography and Thrombin Generation testing in Perioperative Patients with Sepsis, by Dr. Isabelle Gouin-Thibault (France). The first session chaired by Drs. Jim Douketis (Canada) and Jerrold Levy (USA), addressed the Perioperative Management of Antithrombotic Agents: Perioperative Management of Dual Antiplatelet Therapy by Dr. Pierre Albaladejo (France); Rescue Platelet Transfusions by Dr. Thromas Thiele (Germany); Perioperative Management of VKA and DOAC Therapy by Dr. Alex Spyropoulos (USA); and Urgent Perioperative Management of Anticoagulated Patients by Dr. Jerrold Levy (USA). There was vigorous discussion after each presentation, resulting in a 10-min delay to the coffee-break time.   The second session, chaired by Drs. Marc Samama (France) and Beverley Hunt (UK) addressed Perioperative Bleeding: Role of Intraoperative Coagulation Testing by Dr. Beverley Hunt (UK); Use of Increased Plasma/Platelets to RBC ratio by Dr. Anne Godier (France); Fibrinogen/Cryoprecipitate Use in the Perioperative Setting by Dr. Marc Samama (France); and PCC Use in the Setting of Massive Perioperative Bleeding by Dr. Simon Stanworth (UK). As with the first session, there was vigorous discussion, leading to a delayed end of the session at 6:45PM. Overall, the session was considered to be of high interest by ISTH members given the excess in attendees and accompanying excess in questions. We believe interest among ISTH members and accompanying research will only increase with the transition of the Working Group to bona fide SSC Subcommittee. Respectfully submitted,   James Douketis and Marc Samama, Co-Chairs of Perioperative Working Group on T&H
by J. Douketis
Thursday, June 9, 2016
2015 Annual Minutes 0 L. Schmeidler Chairman: James Douketis   1)      Review of the Session: This 2-hour session began with an Introduction by Jim Douketis, outlining the goals of the Perioperative Working Group, its multidisciplinary make-up and ways for ISTH members to become involved. The first presentation by Pierre Albadalejo outlined the challenges in the perioperative management of patients who are receiving dual antiplatelet therapy. This was followed by a presentation by Jerry Levy, outlining the biological basis for managing anticoagulant-associated bleeding. After a discussion period, the third presentation by Marc Samama identified gaps in knowledge relating to laboratory monitoring and administration of different pro-hemostatic agents in the perioperative period, outlining a call-to-action for the Working Group to lead. The final presentation, by Alex Spyropoulos, reviewed and critiqued recently completed and ongoing randomized trials addressed perioperative anticoagulation. Overall, the session was very well-received, with standing-room only attendance of ~150 people.   2)      Future leadership and activities of (applied for) Subcommittee on Perioperative Thrombosis and Hemostasis: Originally, group was formed with a non-hierarchical structure with Jim Douketis as the de facto chair due to linkage with the SSC. With proposed application to a bona fide Subcommittee of the SSC, there is a need for a more structured organization, with a Chair and Co-chairs. There was unanimous agreement that Marc Samama would be the proposed Subcommittee Chair and other current Working Group members would be Co-chairs.   3)      Guidance and guideline development: There was consensus that the field of perioperative thrombosis and hemostasis was a fertile area for guidance document development, including guidance on the topics presented during the educational session. The new Chair, with the assistance of the Co-Chairs would identify and prioritize potential guidance projects, also identifying more junior ISTH members as co-authors. There was general agreement that development of formal practice guidelines was beyond the scope of this group and, indeed, not a direction (at this this time) that was being pursued by the ISTH.   4)      Research activities: The Working Group identified 2 broad areas of research involvement: 1)      Facilitating research led by Working Group members or other colleagues by providing input and expertise. For example, members could be called up to serve as Steering Committee members or act in another advisory capacity. In addition, members would serve a conduit to collaborative research networks in their home country. 2)      Developing de novo multi-center clinical trials would be an important goal of this group, building on research networks developed by individual member; there would be the potential for concurrent applications to funding agencies across countries.   5)      Potential future studies: Yaron Shargall, a thoracic surgeon at McMaster University, Hamilton, Canada discussed a proposed randomized trial assessing VTE prevention after thoracic surgery, with feedback provided. The group encouraged Dr. Shargall to continue this research, where evidence is lacking about best practices, and would provide ongoing feedback and, if needed, participation in the study organization. 
by L. Schmeidler
Wednesday, July 1, 2015
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