Dr AS Soin, consultant liver transplant and hepatobiliary surgeon, Jaslok Hospital, Mumbai, shares details about the new liver clinic۔
1. Jaslok Hospital is a leading super specialty hospital in Mumbai..
What was the need to start the liver clinic?
Jaslok Hospital is a leading super specialty hospital in western India where the most complex diseases are treated and advanced surgeries are performed. While liver diseases have been treated at Jaslok over the years, we have now completely re-vamped our liver facility to match the best in the world. With India’s most experienced liver team, a new stateof-the-art liver ICU and operating rooms, equipment and instrumentation to match, Jaslok is now at the forefront of cutting edge liver medicine. Hence the need for this ‘special liver clinic’ that will cater to adults and children suffering from liver diseases or liver cancer.
When was the liver clinic started?
How many patients have benefited from the clinic?
The new liver clinic at Jaslok Hospital was started in February 2017. So far, we have consulted more than 125 new patients with advanced liver disease or liver cancer, and followed up nearly 100 patients on whom we have done liver transplants.
Who are the key members of the liver transplant programme at Jaslok?
The core members in the liver transplant team at Jaslok Hospital include me, Dr Ankur Shah, Dr Pravin Agrawal- consultant liver physician (hepatologist), Dr Jayshri Shah, consultant liver transplant anesthetists, Dr Rajshree Agaskar, Dr Aparna Budhkar, Dr Shivani Kudwaconsultants in liver intensive care, Dr Indraneel Raut, Dr Shruti Tandon and Dr Anand Babhor. In addition, there is a supporting team of renowned gastroenterologists, nephrologists, cardiologists, radiologists, pathologists, blood transfusion experts, specially trained liver nurses, dieticians and physiotherapists who play an important role in every transplant.
When should a liver transplant be performed?
A liver transplant is needed for acute liver failure, chronic liver failure or liver cancer that is confined to the liver. Acute Liver Failure (ALF): In ALF, patients are suddenly afflicted with liver failure within a few days or weeks, and often need an emergency liver transplant to save them. The common causes of ALF in adults are Hepatitis E, Hepatitis A or drug-induced hepatitis. In
children, a copper metabolism disorder called Wilson’s disease is the commonest cause. Chronic Liver Disease (CLD) or Cirrhosis: In adults, the common causes of cirrhosis or chronic liver failure are Hepatitis C, alcoholic liver disease or
non-alcoholic fatty liver disease.
In children, the commonest causes are biliary atresia or metabolic disorders. A liver transplant is needed once the disease has progressed to a point where the person cannot continue their usual work or normal quality of life, at which stage their life expectancy without transplant is one year or less. There are internationally accepted disease scores (CTP, MELD) which help liver experts in deciding the right timing for a transplant.
In general, a transplant is needed for patients who have developed complications (decompensation) of cirrhosis like bleeding, encephalopathy, ascites, kidney or lung dysfunction, and livercancer. These are usually planned surgeries.
Based on the urgency and availability of a family donor, we advise them to undergo either live donor or deceased (cadaver) donor liver transplantation.
Which patients are excluded from liver transplantation procedure?
Following patients are not advised liver transplant:
a) Patients who have very stable early chronic liver disease (low MELD & CTP score).
b) Patients who harbour active infection in the body.
c) Patients with liver cancer that has spread outside the liver.
d) Patients who are not fit to undergo transplantation surgery because of there associated diseases of the heart, lungs, brain or kidney.
e) Patients with alcoholic liver cirrhosis who are not abstinent from alcohol. f ) Patients who are not of sound mental health.
How experienced is the team in liver transplantation at Jaslok?
My team has performed more than 2,500 liver transplants– the highest in India. Prior to my joining, 45 liver transplants were performed at Jaslok.
What kind of facility does the hospital have for conducting a successful liver transplant?
a) Highly experienced, liver transplant surgeons & hepatologists are available 24×7 for preoperative evaluation, conducting liver transplant surgery and monitoring them after surgery.
b) An experienced liver transplant anaesthesia team.
c) A team of liver intensivists specially trained to take care of liver transplant patients.
d) State-of the art OTs to conduct liver transplantation.
e) Dedicated liver intensive care unit for monitoring patients after transplantation.
f ) Specially trained and experienced liver nurses in the operating room, ICU and ward.
g) A robust support of allied departments such as cardiology, pulmonology, nephrology, radiology, pathology, laboratory and blood transfusion medicine, etc.
h) A modern 24×7 laboratory and diagnostic imaging services for conducting all required tests in-house.
What kind of liver transplant does it offer? We offer international standards of care for both living donor and cadaver donor liver transplantation in adults and children.
Dr AS Soin Know Dr AS Soin, Director and Chief Liver Transplant Surgeon, Jaslok Hospital Dr Soin has performed more than 2,000 living donor liver transplants in India, which is the highest in the country, and the second highest in the world. He and his team currently perform 22-25 live donor liver transplants every month with 95% success - results which are on par with the world's best centres. Apart from referrals from all over the country, he handles cases from the rest of South Asia, The Middle East and Africa. In his extensive experience of 21 years as a liver transplant surgeon and hepatobiliary surgeon, he has performed more than 1,500 liver transplants and more than 12,000 other complex liver, gall bladder and bile duct surgeries.
Jaslok Liver Clinic timing:
Monday to Saturday-9am to 12pm;
For appointment, call: 9594952354;
For more details, visit: http://www.jaslokhospital.net