CHETTINAD INSTITUTE OF LIVER SCIENCES (CLIS)

Overview:

Chettinad Institute of Liver Sciences is an integral component of Chettinad Super Specialty Hospitals, the most rapidly growing super-specialty hospital in India. A centre for excellence in learning, teaching, research, health care, and service to the community It is a dedicated institute offering all levels of treatment for liver diseases, including cancer, for both adults and children.. As the major tertiary service, we deliver the highest level of patient care, consistent with Chettinad philosophy - "Offer quality health service to all strata of society". Chettinad Super Speciality Hospital, Chennai, with its team of dedicated doctors and world class infrastructural facilities, provides excellent health care services. Experienced doctors combined with advanced diagnostic facilities, care for our patients with compassion and concern. Chettinad Health City, the first of its kind in India, was launched by the Chettinad Group of Institutions in 2005 to create a new benchmark of excellence in healthcare, education, and research. To achieve this objective, it already has to its credit a world-class medical college, dental college and nursing college with a combined annual intake of 350 students. CHC also has a research institution to promote advanced research activities in the field of medical sciences, and a SuperSpeciality Hospital that offers quality healthcare of international standards.



Located just 30 km away from Chennai in South India, Chettinad Health City nestles in a lush, green, eco-friendly campus. It has over 1.2 million sq. ft. of built-up area, and encompasses a community of students, researchers and healthcare professionals dedicated to improving the health of the whole larger community of which they are a part.

Transforming lives to become India's one of the most trusted and valued healthcare network. We are here to provide the best of health care "CENTRE OF EXCELLENCE". Combining the best specialties and equipment to provide you nothing short of the best in healthcare. The Institute works closely with all allied departments cohesively and provides state-of-the-art care to patients with liver diseases by offering advanced treatment options like liver transplantation and Hypothermic Machine Perfusion for organ transplant.

Mission statement

Patient centric, state-of-the art abdominal transplant services delivered with credibility and reliability.

Our vision

"Liver Care for All"

Who are we?

CLIS is a unique adult and pediatric multi-visceral transplant group comprised of internationally renowned and experienced transplant surgeons whose repertoire includes liver, liver-kidney, pancreas-kidney, and intestinal/multi-visceral transplantation.

What is special in what we do?

The Liver Transplant Team at CLIS have a cumulative experience of more than 2500 live-donor liver transplants, the largest combined experience of its kind in the world, with internationally comparable clinical outcomes and transplantation rates.

CLIS have developed and embraced novel surgical techniques in live donor liver and cadaveric transplantation ensuring the shortest wait and best outcomes on the list.

Dr.Karthik Mathivanan Head and Clinical Lead CILS is Skilled in Clinical Research, Medical Education, Medicine, Patient Safety, and Hospitals. Strong consulting professional with a Fellowship in liver transplant and Hepatobiliary surgery from Medanta institute of liver transplant. Has worked at Medanta -The Medicity, Delhi as a consultant which is the the most prestigious and world's 2 nd Largest Liver transplant programme. He has an experience of being a core team member performing more than 1500 Living as well as Deceased Donor Liver Transplant to his credit. He has specialized in complex donor and high-risk recipients.

Machine perfused Liver:
Next generation technology for preservation of livers using normothermic oxygenated blood. Physiological resuscitation of livers that may have taken an unknown hit during the pre declaration time. Testing is done on a machine and not on the patient. Data suggests that the outcomes are consistent, reliable and reproducible.

How do we deliver our service?

A seamless patient pathway from pre-surgery management, through transplant surgery and postoperative care makes CLIS a favored destination for patients from within the country as well as globally.

Why should a patient come to us?

CLIS is a one-stop center for pediatric as well as adult multi-visceral transplantation, including ABO -incompatible, domino, dual lobe and swap liver transplantation.

  • Effect of a non- functioning organ
    • Liver failure occurs when parts of the liver become damaged beyond repair and the liver is no longer able to function. Liver failure has a number of consequences. If you have liver failure initially you will have:

       Nausea
       Loss of appetite
       Fatigue
       Diarrhea

      As the liver failure progresses, the build up of bile in your body will cause the following

       Yellowing of your eyes and skin.
       Itchy skin
       Weight loss
       Sleepiness and mental disorientation
       Swollen abdomen

  • Diseases resulting in liver faliure
    • Many conditions can occur as a result of a non-functioning liver. Here are a few:

       Fatty liver (Cholesterol or triglycerides can accumulate in the liver).
       Cirrhosis of the liver (Scarring of the liver).
       Oesophageal varices (protruding blood vessels as a result of liver failure).
       Alpha-one anti-trypsin deficiency (a birth defect with a missing enzyme).
       Primary biliary atresia (bile ducts don't form properly).
       Alcoholic liver disease and other drug-induced conditions.
       Hepatitis (A, B, C and others) may affect liver cell functioning.
       Wilson's disease (disorder of copper metabolism).
       Ascites (fluid build-up in the belly).

  • Treatments for a non-functioning liver
    • Treatments for liver failure may depend on the conditions or disease that led to liver damage and or may not be reversible. In many occasions there is a treatable cause and the liver may recover after treatment and resume its normal functions. e.g. If the liver failure was due to a virus, the liver often recovers with supportive care once the virus has run its course.

      One of the most common causes of liver disease is alcohol abuse. Alcohol is directly harmful to the liver and can cause inflammation of the liver (hepatitis). The first course of action in alcohol related liver disease should be to stop causing injury to the liver by ceasing consumption of alcohol.

      In case of diseases like Wilson's disease the management is in reducing copper consumption in food and water. Additional medications may assist in this effort.

      In other cases of liver failure, it may be necessary to be considered for a liver transplant. A referral to a liver transplant unit is required for an assessment to take place in order to determine suitability. Many people are not suitable for a variety of reasons.

  • Donation
    • Organ donation of a liver ideally is matched as closely as possible to both blood type, as well as to the size of the potential recipient to the donor. However in emergency situations, blood group incompatible Liver transplants are performed and wide differences in size are accepted, if there is no alternative. Liver transplantation requires that the recipients' diseased liver is removed and the donor's liver is put in the same place as the diseased liver. This is known as orthotopic transplantation. In some instances, larger livers can be cut down to reduce their size, and the cut down portion may be transplanted into a child or small adult.

      Source and number of donors. Most liver donors come from deceased (cadaveric) organ donors. In rare instances, a living liver donor can donate a lobe of their liver to a relative or friend, however, the risks to the "healthy" donor are considerable, and thus this option is not taken lightly by the medical staff of the transplant unit.

  • Donor operation
    • Deceased Donor operation. After death of the donor, the liver retrieval team goes to the donor hospital, while blood tests are being performed, and potential recipients identified. Along with other retrieval teams for other organ types, the organs are removed in a careful and precise order to maintain as many blood vessels and bile duct structures as possible.

  • Transplant reciptant selection & reciptant preparation for transplant

    • Transplant recipient selection

      If you are waiting for a liver transplant, you will be evaluated according to a rigorous protocol and placed on a waiting list by your transplant unit. Your eligibility to receive a transplant will be based on factors including urgency, blood type, size, ability to receive an organ. If a hospital in the same state as the donor cannot appropriately match a potential waiting recipient, the organ is offered interstate.

      Recipient preparation for transplant

      Once you have been identified as a potential match for a donor, you will be contacted and asked to come to the hospital. Often two potential recipients are called in case the first choice has an issue that makes them unsuitable to proceed to transplant e.g. in infection. It will often be many hours between receiving the call and being prepared to go to surgery.

  • The surgical operation

    • The surgical operation

      If you are waiting for a liver transplant, you will be evaluated according to a rigorous protocol and placed on a waiting list by your transplant unit. Your eligibility to receive a transplant will be based on factors including urgency, blood type, size, ability to receive an organ. If a hospital in the same state as the donor cannot appropriately match a potential waiting recipient, the organ is offered interstate.Liver transplant surgery requires opening up the belly from the navel to the sternum and also to the side. The surgeons will remove the diseased liver maintaining as many blood vessels and bile duct lengths as possible. Once completed, the bile duct should already be producing bile before closing up the abdominal wound.

      Immediate recovery from the operation

      After the operation, you will be sore!! However, the liver should be working, and almost immediately the yellow in your skin and eyes will start to fade. Apart from checking for infections and the like, the week or so after the operation is spent adjusting the medication dosage so they are right for you. The time spent in hospital after the operation can range from a week to several weeks and depends on how quickly you can regain strength and how rapidly the liver function blood tests become stable.

      Immune suppression and other medications

      You will be on immunosuppression medication for the rest of your life, to prevent rejection. Many such medicines also have additional side-effects, for which other medication may be given. To reduce the amount of immune-suppression medication you need to take, additional medications, such as prednisone are prescribed. Approximately 10% of all transplant recipients become diabetic after transplant. Blood pressure, as well as kidney function, is also monitored closely.

      Organ functioning after transplant

      After the transplant, your organ will probably function perfectly, but maintaining that for the long term require that you look after your transplanted organ. Ensure you keep taking your medication on time and regain physical activity (slowly). Being immune suppressed means that you are now more susceptible than ever to infections and to cancers such as skin cancer.

      Discharge from hospital

      Hospital discharge is an important step, but please remember that many nurses and doctors and other hospital staff have put a lot of effort in your regaining a lifestyle in the community. Ensure that you say “thank you” to everyone you can. They will appreciate it.

  • Recovering at home

    • For at least a few weeks afterward, do not over-do things. But also do not lounge around all day. You should be able to return to a normal lifestyle within a couple of months. Spend the time appreciating those around you and what this generous donation has done to improve your quality and quantity of life.

      Doctors monitoring

      Return to work or other activities only if you feel up to it. It is recommended you start slowly in the first instance. This also includes sexual activity. If in doubt, ask your doctor. Don’t be shy – they have heard it all before.

      Blood tests

      Blood tests are used to monitor your liver and kidney function as well as other blood variables. Blood tests should ideally be done the day or so before your doctor’s appointment so that they have the latest information.

      Stages of returning to activity, including work

      Return to work or other activities only if you feel up to it. It is recommended you start slowly in the first instance. This also includes sexual activity. If in doubt, ask your doctor. Don’t be shy – they have heard it all before.

      Healthy eating

      This is a no-brainer. Do eat healthy food. Everything and anything in moderation. It is highly recommended that you do not eat raw meats (including fish etc) until you are completely stable.

      What to avoid

      Because you are immune suppressed, always check with your Hepatologist if another doctor suggests you should receive any immunisations. The Mantoux test for tuberculosis and immunisations for yellow fever, for example, are forbidden as are any other immunisations using live or weakened bacteria or viruses. However influenza vaccinations or immunoglobulins are okay. Avoid coming into close contact with children or people with chicken pox or measles etc.

      Driving after Transplant Surgery

      You may wish to resume driving as soon as possible after your surgery. You must check with your doctor to clarify when it is safe to drive. You can resume driving after four to six weeks post-transplant depending on the type of surgery you have had and the size of the wound. Before driving, ensure that your wound is healing well, that you are alert and not fatigued, no longer experiencing significant pain or taking medications that can cause drowsiness.

      For information on assessing fitness to drive, please visit the website www.austroads.com.au . The guidelines on this website outline the responsibility drivers, health professionals and the licensing authorities. The rules for driving are very clear and are set out to protect you, the transplant doctors and the general public.

  • Respect your new organ

    • It is highly recommended that you do not drink alcohol after receiving a liver transplant. If you transplant was due to alcoholism, then this is imperative. Respect your new organ as it will be rapidly damaged by alcohol and you will not be eligible for a further transplant.

      Enjoy life

      In most cases, liver transplant recipients have received their new organ after the donor died. You should live your life to the fullest in order to give thanks to your donor’s gift. Think about writing to your donor family anonymously through DonateLife or your transplant unit making sure that you keep your comments anonymous and do not identify yourself.

      Finally, ensure that you ‘make the most of life’.




TRANSPLANT & HPB SURGEONS

Dr.Karthik Mathivanan

Head and Clinical Lead

Dr.Vivekanandan Shanmugam

Consultant

Dr.Rajasekhar Perumalla

Consultant

Dr.Senthil Muthuraman

Consultant

Dr. K. Abhilash

Consultant in General in Laparoscopic Surgeon



GASTROENTEROLOGIST & HEPATOLOGIST

Dr. S. Babukumar

Senior Consultant Medical Gastroenterologist & Hepatologist

Dr. Pugazhenthi

Consultant Medical Gastroenterologist & Hepatologist



TRANSPLANT INTENSIVIST & ANAESTHETIST

Dr.Nivash Chandrasekaran

Consultant

Dr. Dinesh

Consultant

Dr. Mohana Rangam. T

Consultant Anesthesiologist

Dr. R. Sivakumar

Sr. Consultant Cardiac Anesthesiologist.

Dr. Radhakrishnan

Consultant Intensive care and Pulmonary Medicine

Dr. Guhan

Consultant Critical care Department

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More than 350 screened during
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A health check-up camp was organized at
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More than 350 screened during
health camp
Jun 25,2015 to Jun 25,2018

A health check-up camp was organized at
Gobardanga, North 24, Parganas, in
association with Bibekananda Seba Samiti and MCRWA. More than 350 ...

+ Know More

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