Aster Centre of Excellence in Integrated Liver Care

The Integrated Liver Care Unit at Aster Medcity offers highly-advanced services for comprehensive management of complex liver diseases and hepato pancreato biliary diseases in both adults and children. The outstanding team of Doctors comprising Hepato Pancreato Biliary & Abdominal Multi-Organ Transplant Surgeons, Hepatologists, Pancreato Biliary Endoscopy experts, Hepato Biliary Radiologists/Interventional Radiologists and Liver Transplant Anesthesiologists have a collective experience of more than 2600 liver transplants, 200 pancreas and 4000 complex liver, biliary and pancreatic surgeries.

Aster Medcity is the first hospital in the world to perform a simultaneous live-donor liver and kidney transplant on a 20-month old toddler weighing just 7 kilograms and simultaneous liver transplants in one-year old identical twins who suffered liver failure due to accidental poisoning - a first-of-its-kind case in the world.

ADULT HEPATOLOGY

Outpatient Services

• Consultation
• Liver ultrasound
• Fibroscan
• Liver biopsy/FNAC
• Ascitic tap
• Endoscopy
• Liver transplant assessment

Speciality Clinics

• Viral Hepatitis
• Auto immune liver disease
• Jaundice
• Liver transplant
• Liver transplant assessment
• Post liver transplant
• Complex liver diseases
• Chronic liver diseases
• Fatty liver/NASH
• Alcoholic liver diseases
• Alcoholic de-addiction

Specialised Services

• Endoscopy - band ligation, glue injection, sclerotherapy, ERCP
• Dedicated liver ICU manned by liver intensivists, trained nurses
• Liver biopsy/FNAC
• Transjugular liver biopsy
• TIPS (Transjugular Intrahepatic Shunt)
• BRTO (for bleeding)
• TACE
• TARE (Rhenium/Y90)
• Radio frequency ablation (RFA)
• EBRT (radiotherapy)
• Multidisciplinary care for alcoholic liver diseases
• Advanced therapeutic interventions for liver tumours
• Liver intensive care for acute liver failure
• Dedicated liver ward for decompensated liver diseases
• Pre and post liver transplant care

TRANSPLANT HEPATOLOGY

• Pre-liver transplant assessment
• Transplant counselling
• Nutrition optimisation
• Infection screening
• Preventive vaccinations - Hepatitis B/A
• Annual post -transplant evaluation
• Live and deceased donor liver transplantation

PAEDIATRIC HEPATOLOGY

• Assessment of neonatal jaundice
• Management of congenital liver diseases
• Biliary atresia management
• Paediatric liver transplant
• Live and deceased donor transplant
• Paediatric hepato oncology

HEPATOBILIARY ENDOSCOPY

Upper GI endoscopy

• Variceal ligation (banding)
• Glue injection
• Sclerotherapy
• Esophageal stents for bleeding

ERCP

• For stones, strictures
• Metallic stent palcements
• Spy glass cholangioscopy

Endoscopic Ultrasound (EUS)

• Diagnostic
• Staging
• Therapeutic

HEPATO PANCREATO BILIARY SURGERY

Day care surgery/procedures for

• Liver abscess drainage
• Pain relief from cancer
• Pain relief for chronic pancreatitis
• Gall bladder surgery

Liver Resection For

• Primary liver cancers (HCC)
• Hilar Cholangio carcinomas
• Secondary liver tumours
• Bile duct cancers
• Gall baldder cancers
• Benign liver tumours - Adenoma

Biliary Surgery

• Bile duct injury - biliary reconstruction
• Choledochal cyst
• Biliary strictures
• Palliative bypass
• Bile duct stones

Pancreatic Surgery

• Whipple’s pancreaticoduodenectomy
• Distal pancreatectomy
• Frey’s procedure
• Biopsy

Laparoscopic Hepato Pancreato Biliary Surgery

• Major hepatectomy (liver resection)
• Minor hepatectomy
• Bile duct exploration for stones
• Laparoscopy assisted tumour ablation/biopsy
• Pancreatetctomy
• Surgery for chronic pancreatitis
• Minimally invasive necrosectomy

Robotic Hepato Pancreato Biliary Surgery

• Hemi hepatectomy for liver cancers
• Bile duct explorations
• Bile duct reconstructions
• Cholangiocarcinomas
• Pancreatic resections
• Splenectomy

Speciality Clinics

• Liver tumour
• Neuroendocrine
• Sarcoma
• Biliary cancer

Liver Trauma

24/7 on call services for management of injuries of the liver, including advanced intensive care management, interventional radiological and surgical treatment.

Hepato Biliary Oncology

Surgical/non-surgical management of complex hilar carcinomas, metastatic liver tumours, primary liver cancers, with a multidisciplinary approach.

MULTI-ORGAN TRANSPLANT

• Liver transplant
• Pancreas transplant
• Abdominal multi-organ transplant

Liver Transplantation

• Live donor liver transplantation
• Deceased donor liver transplantation
• Split liver transplantation
• Combined dual organ transplantation
• Multi visceral transplantation

Paediatric Hepato Pancreato Biliary /Liver Transplant

• Liver transplant for Hepatoblastoma
• Liver resection for primary liver tumour
• Multidisciplinary treatment for Hepatoblastoma
• Biliary Atresia
• Biliary diversion for PFIC
• Liver donor liver transplant

ADVANCED SUPPORT SERVICES

Hepatobiliary Radiology & Interventional Radiology

• Advanced 3D imaging
• Liver MRI
• Percutaneous transhepatic biliary drainage and stenting for biliary strictures
• Portal vein embolisation
• Radiofrequency ablation of liver cancers
• Intra operative Doppler studies
• Transjugular liver biopsy
• Hepatic venous pressure gradient measurements to assess portal hypertension
• Transjugular intrahepatic portosystemic shunt (TIPS) for variceal bleeding

Nuclear Medicine

• HIDA Scan (Hepatobiliary Scintigraphy)
• Liver Spleen Scintigraphy
• Techtenium RBC Labeled Blood Pool Scintigraphy
• Yttrium 90 SIR Sphere Therapy for metastatic liver tumour patients who are no longer responding to chemotherapy/ those with primary liver care cancer that cannot be surgically managed
• PET scan for cancer staging
• TARE - Transarterial Radioembolisation (Rhenium/Y90-SIRT)
• DOTA PET scan for neuro endocrine tumours

Hepato Pancreato Biliary & Transplant Pathology

• Immunohistochemistry
• Liver transplant pathology
• Molecular diagnosis and genetic mutation analysis

Advanced Technology

• Dedicated OR 1 Karlstorz fusion integrated transplant surgical suites
• Green OT Certified Operation Theatres with autopilot anaesthesia
• Dedicated ICCA (IntelliSpace Critical Care and Anaesthesia) transplant ICUs
• Level 3 Paediatric ICU
• India’s first independent ICUs with a view
• Kerala’s first da Vinci Surgery Robot
• Highly advanced Infection Control: Air is HEPA Filtered to 0.3 microns
• India’s first flat panel bi-plane vascular hybrid cathlab
• Kerala’s first fourth generation Time of Flight 16 Slide PET CT
• GE SPECT-CT OPTIMA NM 640 Gamma Camera EPIQ
• 3 Tesla Wide Bore Digital MRI
• 256 slice Philips iCT scanner
• State-of-the-art lab

NUTRITIONAL REHABILITATION

Expert clinical nutritionists to provide dietary advice/plan a healthy, balanced diet for the patient.

TRANSPLANT REHABILITATION

• Physical therapy
• Occupational therapy
• De-addiction and rehabilitation for patients with substance abuse
• Psychotherapy and behavioural therapy
• Counselling services
• Quality of life assessment pre and post-transplant

TRANSPLANT COORDINATORS (FOR LIVER & PANCREAS TRANSPLANT)

• Pre-transplant clinic visits
• Registration for transplants
• Single point of contact
• Post-transplant clinic visits