Hepatology department at PVS Memorial Hospital is headed by trained Hepatologists and Transplant Physicians and encompass a comprehensive unitproviding advanced and protocol based patient care, and with focus also on student/physician training and bench to bedside research. The unit provides emergency and elective management to patients of liver and biliary tract disease with a highly dedicated team of senior consultants, residents and supportive staff. With a rigorous approach to patient based care, the department of Hepatology always strives to manage the most difficult to treat liver disease patients from all over the State.
Newer Translational Treatments in Liver Disease at PVS Hospital
Novel therapies that demonstrate benefits in liver and multi organ function are used as a bridge for natural recovery or transplantation in patients with severe liver disease. Especially in patients with acute on chronic liver failure (ACLF) (withor without contraindications for transplantation) our department provides Plasmapheresis (membrane plasma exchange) for improving survival and as a bridge to definitive therapy. Similarly, for severe drug induced liver injury, we perform plasma exchange treatment for early recovery or as bridge to transplantation.
Liver Regeneration Therapy for Chronic Liver Disease at PVS Hospital
In the Hepatology Department and Transplant Medicine at PVS, we always strive to improve the patient condition no matter what. In advanced liver disease, medical management is seldom useful after a particular point in the natural history of the disease. Such patients require liver transplantation for cure but may not be able to undergo the same because of multiple issues. For such patients, we offer the simple medical treatment with different types of growth factors (liver regeneration therapy) for improved survival and sustainability on the liver transplant listing to undergo a curative treatment.
Non-invasive diagnosis of liver cirrhosis
Point Shearwave Elastography (liver stiffness measurement): Liver stiffness measurement is utilized in assessing the stage of liver disease and also confirms evidence of cirrhosis. The point Shearwave elastography (pSWE) technique is used to quantify hepatic fibrosis in a totally non-invasive and painless manner, without anyproblems/contraindications and is currently available at PVS Hospital, one of the very few centers in the country to bring this new technology that could eliminate the need for liver biopsies.
Hepatology – Basic and Advanced Services
Adult Hepatology Services: Diagnosis and treatment of viral hepatitis (Hepatitis B, C, E, A and D), alcoholic liver disease, fatty liver disease, auto-immune hepatitis, drug related liver disease and all causes of jaundice. Gall stones and bile duct stones; pancreatic diseases; Liver, gall bladder and GI cancers. A 24 hour Liver Intensive Unit is equipped to manage the most severe and difficult liver disease patients.
Special Liver Services
- Advanced diagnostics and management of fatty liver disease
- Advanced and translational management of severe alcohol liver disease
- Fecal microbiota transplantation (Stool transplant) unit for severe liver disease
- Gastrointestinal (GI) bleed unit: Patients with acute GI bleed are triaged immediately in the emergency room and immediate emergency endoscopy (24x7) is instituted urgently, leading to an improvement in survival. Patients who fail the basic treatment protocols are quickly bridged to life saving salvage therapy such as esophageal stenting or emergency TIPS procedure with the help of dedicated Hepatologist and Intensivist who are available round the clock.The interventional radiology teams works along with the Hepatology department to provide and salvage emergency angio-embolization or radiological obliteration services for difficult to control or inaccessible bleeding areas
- Liver coma unit: Hepatic encephalopathy (also known as cerebral/brain failure in liver disease) is when there is confusion, altered level of senses, and coma as a result of liver failure which may or may not lead to death. These patients are managed with the state of the art hepatic coma ICU at PVS Medical Intensive Units with dedicated Liver services.
- Liver Pressure and flow measurement and intervention suite [Hepatic Hemodynamic Laboratory]: Hepatology services provided by activities in this department providedetails of liver pressure which determines the outcome of patients with liver disease. Decreasing liver pressures leads to reduction in liver related complications. Measurement of the hepatic venous pressure gradient (liver pressure or the HVPG) is the best modality to assess for the presence and severity of portal hypertension (a condition that happens due to cirrhosis). We perform this safe and simple procedure with ease and panache as per global guidelines to optimize drug therapy or change to another form of therapy.
- Liver biopsy (both percutaneous and trans-jugular)
- Other interventions: Treatment of liver cancers with the latest cutting edge management such as Radiofrequency Ablation (RFA), Transarterial Chemoembolization (TACE or deb-TACE) or Systemic chemotherapy leading to improved survival.
- Advanced Hepatology interventional services: Management of medication resistant encephalopathy/cerebral failure in cirrhotics using Coil or Plug assisted transvenous occlusion (CARTO or PARTO) or Balloon retrograde transvenous occlusion (BRTO). Our adept Hepatology and Interventional Radiology team has performed the first PARTO/CARTO procedure in Kerala for patients with severe recurrent hepatic encephalopathy/coma with excellent outcomes.
Dr. Prakash Zacharias
MD, DM Associate Director, PVS Institute of Digestive Diseases
Dr. Cyriac Abby Philips
MD (Int. Medicine) , DM (Hepatology & Liver Transplant Medicine), Associate Director Hepatology & Chief of Liver Transplant Medicine
Dr. Lijesh Kumar
MBBS, MD, DNB