The Integrated Liver Care (ILC) Centre of Excellence (CoE) at Aster Hospitals provide complete care for patients with all the aspects of a liver ailment ranging from medical care, complex liver and pancreas resections, interventional radiology procedures, including robotic hepatectomy and the complete range of both paediatric and adult liver transplant. The department of Integrated Liver Care consists of leading liver transplant surgeons, liver specialist doctors, and the entire team to attend cases with complex liver conditions. Each member in the team are trained at some of the top hospitals specialising in liver treatment abroad and are experts in hepato-pancreato biliary and abdominalmulti-organ transplant surgeries.
The department of ILC at Aster is a one stop destination for a patient suffering from any tupes of liver condition. Aster Hosptials ILC department is equipped with modern infrastructure, dedicated Liver ward, transplant ICU, single and double rooms, the Advanced Therapeutic Endoscopy unit (ERCP, EUS), and MARS Liver dialysis unit. Also, all non-transplant patients can get advantaged from a large ICU.
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- Thorough medical assessment for patients with complex liver diseases
- Specialized care for pediatric liver transplantation
- Intensive care for individuals with acute liver failure.
- Liver transplantation, encompassing live donor, deceased donor, and split liver procedures
- Autoimmune Liver Disorders
- Viral Hepatitis Management
- Chronic Liver Disease Clinic
- Post-Liver Transplant Care and Follow-up
24/7 neuro trauma & critical care
Dedicated Neuro ICUs
Carotid ultrasound and transcranial doppler
Diagnostic cerebral angiography
Thrombolysis and mechanical thrombectomy for stroke
Angioplasty and stent for stroke management
Inpatient electrophysiological procedures including: Long-term video EEG Invasive intracranial monitoring Sleep lab Nerve conduction and evoked potential studies (somatosensory, motor, visual & auditory) Intraoperative electrophysiology
- Utilization of Advanced 3D Imaging
- Portal Vein Embolization
- Implementation of Percutaneous Transhepatic Biliary Drainage and Stenting for Biliary Strictures
- Physical Therapy
- Occupational Therapy
- Support, Deaddiction, and Rehabilitation for Substance Abuse
Medical evaluation of patients with complex liver disease
Management of patients with cirrhosis, end stage liver disease and liver failure
Intensive care management of acute liver failure
Liver pathology
FAQs
Want to find out more about the treatment? The answer to your questions can be found below.
What are the types of liver cancer (Hepatocellular carcinoma)?
There are mainly five types of liver cancer based upon the type of cell in the liver. Hepatocellular carcinoma (HCC) Hepatocellular carcinoma (HCC) is a common type of primary liver cancer which affects the main liver cells called hepatocytes. People with cirrhosis and men are more prone to get Hepatocellular Carcinoma. Fibrolamellar carcinoma Fibrolamellar carcinoma is rare liver cancer, it comes as a subtype of Hepatocellular carcinoma and usually seen in healthy teens and adults under 40 years old. Interestingly, people diagnosed as Fibrolamellar carcinoma is not usually associated with liver cirrhosis or Hepatitis B or C infection. Cholangiocarcinoma (bile duct cancer) Cholangiocarcinoma is a rare liver cancer of the bile ducts, also categorized under primary liver cancer. The carcinoma begins in the section of ducts inside the liver is called intrahepatic cholangiocarcinoma. Angiosarcoma Angiosarcoma a type of rare liver cancer affects the blood vessels of the liver; it is commonly seen in the elderly population. Angiosarcoma is also known as soft tissue sarcoma or haemangiosarcoma. Hepatoblastoma: Hepatoblastoma is a kind of rare primary liver cancer that mainly affects children under 3 years old.
What causes liver cancer?
In some scenarios the cause of liver cancer is identified, for instance chronic hepatitis infection damages the DNA in the liver cells and cause liver cancer. Sometimes liver cancer occurs in patients with no underlying health conditions and it's not clear what causes it.
What are the prevention methods for liver cancer?
When it comes to prevention of liver cancer, it is really important to maintain a healthy lifestyle by doing regular exercise and following a balanced diet. Also, avoid hepatitis infection and exposure to cancer-causing substances such as aflatoxins, a toxin found on agricultural crops such as maize.
How liver cancer is treated?
Treatment of liver cancer depends upon various factors, it includes the extent of the liver cancer, patients age, health conditions and personal preferences. Surgery: In liver surgery, the liver cancer cells and small portion of healthy liver tissue is removed to promote liver health. Liver transplant surgery: In liver transplant surgery the diseased liver of patient is replaced by whole or partial healthy liver from another person. Heating cancer cells. This is a minimally invasive procedure; the cancerous cells are ablated by using heat generated from medium frequency electric current. Freezing cancer cells: liquid nitrogen is used to freeze the cancer cells with the help of a surgical instrument (cryoprobe) Alcohol injection: In this method alcohol is directly injected to the tumour to treat liver cancer. Injecting Chemotherapy drugs: Injecting chemotherapy drugs directly to the liver is known as chemoembolization, it can be done as stand-alone treatment or in combination with ablation or surgery.
When is a liver transplant indicated?
Liver transplantation is indicated when a person's liver is severely damaged or failing to the extent that it can no longer perform its essential functions. The most common reasons for a liver transplant include:
End-stage liver disease
Liver cancer
Acute liver failure
Biliary atresia and paediatric liver disease
Metabolic liver diseases
Severe liver damage due to chronic infections like hepatitis B or C
How are choledochal cysts treated?
Choledochal cysts are congenital cystic dilations of the bile ducts, and they can pose a risk of complications such as infection, stone formation, and an increased likelihood of developing bile duct cancer. The standard and most common treatment for choledochal cysts involves the complete removal of the cyst. The affected portion of the bile duct is resected, and the remaining healthy bile duct is reconstructed to restore normal bile flow. After removing the cyst, the surgeon often performs a Roux-en-Y hepaticojejunostomy. This involves connecting the remaining bile duct to a loop of the small intestine (jejunum). This procedure allows the bile to flow from the liver into the intestine, bypassing the area where the cyst was located.
What is the role of surgery in the management of liver cancer?
Surgery plays a crucial role in the management of liver cancer, especially in cases where the tumour is localized and has not spread extensively. The specific surgical approach depends on factors such as the size and location of the tumour, Quality of Liver the overall health of the patient, and the extent of liver function. Some of the most common surgical options for the treatment of liver cancer include:
Hepatectomy: It involves the surgical removal of a portion of the liver. The extent of the resection depends on the size and location of the tumour. The goal is to remove the cancerous tissue while preserving as much of the healthy liver as possible.
Liver Transplantation: For certain patients with liver cancer, especially those with cirrhosis liver transplantation may be considered. In this procedure, the entire liver is replaced with a healthy liver from a deceased or living donor.
Radiofrequency Ablation (RFA) and Microwave Ablation: These minimally invasive techniques involve the use of heat to destroy cancerous tissue. During RFA, a special needle is inserted into the tumour, and high frequency electrical currents generate heat, causing the tumour cells to be destroyed. Microwave ablation utilizes microwaves to achieve a similar result. These techniques are often employed for smaller tumours.
Transarterial Chemoembolization (TACE): TACE involves injecting chemotherapy drugs directly into the blood vessels supplying the tumour, combined with blocking these vessels. This method helps to deliver high concentrations of chemotherapy to the tumour while limiting the blood supply.
Why should I consult a specialist for managing fatty liver disease?
Non-Alcoholic Fatty Liver Disease (NAFLD) is a condition characterized by the accumulation of fat in the liver of those with no history of alcoholism. It is associated with obesity, insulin resistance, and metabolic syndrome. NAFLD is a complex condition, and its management requires a comprehensive approach. Self diagnosis and treatment without professional guidance can lead to inadequate care and potential complications. Consulting a specialist will benefit you in several ways, including
Establishing an accurate diagnosis to guide appropriate management.
Identify the underlying cause and address these factors for effective management.
Assess the risk of disease progression and the development of complications, such as cirrhosis and liver cancer. This helps in tailoring a personalized treatment plan and monitoring the condition over time.
Understand the best management strategies to manage your health including lifestyle modifications and medications.
Follow-up visits will allow your doctor to make necessary adjustments to the treatment plan.
What signs and symptoms may indicate liver problems?
Some of the common indicators that may suggest liver problems include
Jaundice
Persistent fatigue and weakness
Pain and discomfort in the upper side of the abdomen
Swelling in the legs and abdomen
Unexplained weight loss
Dark urine
Pale coloured stool
Nausea and vomiting
Mental confusion, difficulty in concentrating
Easy bruising and bleeding
Itchy skin
Vomiting of Blood
What are the symptoms of liver cancer?
Most of the time the Signs and symptoms of liver cancer do not show up until the later stages, but sometimes the signs and symptoms may show up in the beginning stage. Listed below are the common symptoms of liver cancer of hepatic cancer: You may notice unplanned Weight loss, lack of appetite, nausea or vomiting and a feeling of fullness after having a small meal. Enlarged liver & spleen, pain in the right shoulder blade, abdominal pain and swelling Itching and Yellowing of the skin and eyes (jaundice) People with hepatic cancer may experience fever, enlarged veins on the belly that can be seen through the skin, and abnormal bruising or bleeding. Some signs and symptoms of hepatic cancer include increased blood calcium levels (hypercalcemia), Low blood sugar levels (hypoglycaemia) and high cholesterol levels
What are the main risk factors affecting liver cancer Treatment?
There are many factors which affects the liver cancer treatment which includes Certain liver conditions: - Non-alcoholic fatty liver - Liver cirrhosis developed due to Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Diabetes: Poorly managed type 2 diabetes can make fatty liver and could make the liver cancer worse.
How liver cancer is diagnosed?
Liver cancer is diagnosed by performing following tests and procedures; It is not possible to diagnose hepatic cancer by doing normal blood tests. A specific blood test is done to find levels of alfa-fetoprotein in serum (AFP). Increased levels of AFP indicate presence of liver cancer. Sometimes the doctor may suggest imaging studies such as a CT or MRI scan. Liver biopsy is another method used to identify malignant or benign tumour. It is done is by removing tissue from liver and examining under the microscope, liver biopsy can be done along with CT scan. Another method to identify liver cancer is by doing laparoscopy, in this procedure the surgeon assesses the signs of hepatocellular carcinoma by inserting a flexible tube with a camera and light at the tip (laparoscope) by making a small incision in the abdomen.
What is split liver transplantation?
Split liver transplantation is a surgical procedure in which a single donor liver is divided into two separate grafts, which can then be transplanted into two different recipients. This technique aims to maximize the use of available donor organs and increase the number of liver transplants performed to more Patients in the view of limited Organ Availability.
The liver is a unique organ with the ability to regenerate. This characteristic allows surgeons to split a donor liver into two parts: the larger portion, typically the right lobe, is transplanted into an adult recipient, while the smaller portion, usually the left lobe, is transplanted into a pediatric recipient or small size adult. Both portions of the liver will regenerate to near-normal size within a few weeks to months after transplantation.
What is the Whipple procedure and what does it involve?
The Whipple procedure, also known as pancreaticoduodenectomy, is a complex surgical procedure used to treat tumours and other diseases affecting the pancreas, as well as adjacent organs such as the duodenum, bile duct, and sometimes part of the stomach. The surgery is named after American surgeon Dr. Allen Whipple, who first performed it in the 1930s. The Whipple procedure entails the excision of the pancreatic head, the duodenum, the gallbladder, and the bile duct. After removing these structures, the surgeon reconstructs the digestive tract to allow for the flow of digestive juices and bile into the small intestine. The remaining portion of the pancreas is then attached to the digestive tract.
The Whipple procedure is a challenging surgery and is usually performed by experienced surgical teams. The goal is to remove the diseased tissue while preserving as much normal pancreatic and gastrointestinal function as possible. The procedure can be curative for some patients with pancreatic cancer or other localized diseases, but it requires careful postoperative management and long-term follow-up.
Who is at risk of developing neonatal jaundice?
Neonatal jaundice is a common condition in newborns and is caused by an excess of bilirubin, a yellow pigment produced during the breakdown of red blood cells. While it is a normal and often temporary occurrence, some infants may be at a higher risk of developing neonatal jaundice.
Risk factors may include premature birth, blood type incompatibility of the mother and baby, suboptimal breastfeeding, birth trauma, infections, conditions like cephalohematoma (collection of blood between the baby's skull and periosteum) or history of a previous sibling with neonatal jaundice.
Neonatal jaundice is a self-limiting condition. However, if bilirubin levels become excessively high, it can lead to a more severe form of jaundice called kernicterus, which can cause neurological damage. Treatment options may include phototherapy or, in severe cases, exchange transfusions. Parents should communicate any concerns about jaundice with their paediatrician for appropriate evaluation and management.
Can liver cancer be prevented?
Some of the key strategies to reduce the risk of liver cancer include:
Limit your alcohol intake or, ideally, abstain from alcohol.
Quit smoking.
Getting vaccinated against hepatitis B can significantly reduce the risk of liver cancer.
Practice safe sex and avoid sharing needles or engaging in other high-risk behaviours that could lead to viral hepatitis.
Adopt a healthy diet and exercise regularly to maintain a healthy weight.
Effectively manage chronic conditions such as diabetes and fatty liver disease through lifestyle modifications and medication.
Minimize exposure to aflatoxin B1, a toxin produced by a fungus that can contaminate foods like corn and nuts, especially when stored in hot, humid conditions.
If you have a history of liver diseases or conditions such as cirrhosis, follow your doctor's recommendations for regular screenings and surveillance for liver cancer.
How can Hepatitis B vaccination prevent liver ailments?
The primary goal of the hepatitis B vaccine is to prevent the initial infection with the hepatitis B virus. HBV is a major cause of viral hepatitis and can lead to acute and chronic liver diseases, including cirrhosis and liver cancer. By receiving the hepatitis B vaccine, individuals develop immunity against the virus, reducing the risk of infection.
Certain populations are at an increased risk of hepatitis B infection, including healthcare workers, individuals with multiple sexual partners, people who inject drugs, and those living in regions where hepatitis B is endemic. Vaccination is important for these high-risk groups.
Hepatitis B vaccination also helps prevent co-infection with hepatitis D, which can lead to more severe liver disease.
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