PEDIATRIC COUNCIL Chair- Elfriede Pahl (Chicago) Vice Chair- Beth Kaufman (Philadelphia) Past Chair- Christian Benden (Zurich) Workforce leaders Education: Daphne Hsu (New York) Communications: Anne Dipchand (Toronto) Standards & Guidelines: Robert Boucek (Seattle) Registry & Databases: Richard Chinnock (Loma Linda)

Input to scientific program committee from education Committee-2011 San Diego Two pre-meeting satellite symposia –'preventable death: kids on the wait list' – 'pediatric cardiothoracic transplants: do we have consensus?' [in collaboration with International Pediatric TransplantAssociation] Two mid-day symposia –'update on pediatric MCS therapy – 'ethical issues on pediatric cardiothoracic transplant', Sunrise symposium – 'why are children immunologically different? –'pediatric issues in CMV management - the hinge of fate' as part of an ID pre-meeting symposium on CMV

Input to ISHLT on DCD donation document under preparation. Dr Boucek, representing the standards and guidelines committee, as well as other members of the operating board gave the following comments: Pediatric donation is a surrogate decision without advance directives and there likely will be a more stringent, and therefore "intrusive", timeline to declaration. It is important to note the innate tension between the needs of the surrogate to say good bye and their desire to donate within the minutes of acceptable warm ischemic time for successful Htx. Given the limited experience with HTx after DCD, we advocate a cooperative effort to collect the experience with the equivalent of a data safety monitoring board. Should there be an international committee, perhaps within the ISHLT that would have periodic overview/oversight of DCD-e.g. should a registry be developed where these cases are reviewed? This was a final suggestion.

The Pediatric Registry Reports have been published in the October issue of the Journal of Heart and Lung Transplantation: Kirk R, Edwards LB, Aurora P, et al. Registry of the international society for heart and lung transplantation: 13th official pediatric heart transplantation report-20. J Heart Lung Transplant 20 Aurora P, Edwards LB, Christie JD, et al. Registry of the international society for heart and lung transplantation: 13th official pediatric lung and heart/lung transplantation report-20. J Heart Lung Transplant 20 These are valuable reports, and show continued improvement in survival for stratified age groups, in particular conditional survival for infant heart transplants who have the best long term survival overall.

Key discussion points and action items for the Board 1. Would the Board consider the next Elsevier Monograph to include Do we have Consensus for guidelines in Pediatric Heart Transplantation 2. There has been discussion and interest raised by Pediatric Vice Chair, Beth Kaufman on developing an interest group and/or new workforce related to ethical issues in pediatric cardiothoracic transplant. The goal of this group would be to provide a forum for discussion and to eventually develop some international consensus guidelines for common ethical dilemmas, mainly related to criteria for transplant candidacy. What is the process/ format to proceed?

Items needing budget consideration (include amount requested and rationale) 1. Budget for conference calls- $600 planning for joint session at IPTA (2 calls) -2 nd session on do we have consensus for pediatric cardiothoracic Tx will be in Montreal,June 2011 Education committee calls (4 calls)- 2. Information page on the ISHLT website for the Pediatric Council for recent publications with pediatric focus, and other topics of interest for the pediatric membership

Goals and plans for coming year 1.Work on the 'ISHLT monograph on pediatric lung transplantation' is underway. 2.Joint Symposia at IPTA-Montreal is planned for June, Do we have consensus? The first session takes place at ISHLT/San Diego followed by a second joint session in Montreal June,2011. There will be 2 conference calls in the near future, among the speakers for the ISHLT session to plan the IPTA session- 3.These consensus guidelines could eventually be published – as a monograph, or in J HLTx or Peds Transplantation 4.Education Committee to discuss feasibility of a pediatric heart failure workshop for Prague- ISHLT 2012 Conference (conf call planned) 5.Education committee to discuss creating a listserve/similar to adult heart failure committees efforts

Conclusion The ISHLT pediatric council looks forward to an exciting year with a vibrant meeting in San Diego, collaborations with IPTA in Montreal In addition, the workforce leaders would like to have expansion to more international members and more involvement from our current members