Dr JOY LIVER
                     Dr. Joy Varghese
JOY LIVER CARE
Doctor’s 
profile
Dr. Joy Varghese is a Director in Hepatology & Transplant Hepatology, 
Institute of Liver Disease & Transplantation, Gleneagles Global Heath 
City, Perumbakkam, Chennai. He is a visiting Consultant Hepatologist & 
Liver Transplant Physician and member of teaching faculty in 
Department of Hepatology and Institute of Liver Transplantation in Govt. 
Stanley Medical College Hospital, Chennai. He is also an Adjunct 
Professor in Department of Medical Gastroenterology –SRM Institute of 
Science & Technology, Chennai.
He has played a vital role for setting up cadaver liver transplant 
programs in various hospitals across Tamil Nadu and Kerala in the 
Government & Non-Government sector.  He has recently received 
the Best Doctor Award 2018 – 2019 – By Government of Tamil 
Nadu, and the Medical Excellence Award 2018 – 2019(received 
from Honourable Governor of Kerala). He has been serving as a 
respected editor for international journals that include the prestigious 
"World Journal of Hepatology".
List of Notable Awards
1. Einthoven prize in Electro cardiology - First prize out of 70 M.D. postgraduate students 
and Association of Physician of India (A.P.I.) Medal in M.D. (Internal Medicine)
2. Levy Thomson Award for clinical research work on “Understanding pathophysiology of 
hyperventilation in Cirrhosis” – Received at Canadian Digestive Disease Week, Banff, 
Canada in 2007.
3.Indo – British “Young Investigator Award” – for clinical research work on “Hyper-Immune 
plasma in Post Liver Transplantation” at MIOT hospital, Chennai.
4.Best Doctor Award 2018 – 2019 - By Government of Tamil Nadu.
5. Medical Excellence Award 2018 – 2019 - Received from Honourable Governor of Kerala  .
KNOW YOUR DISEASE
• How to protect Liver?
• Fatty liver disease
• Hepatitis B&C
• Liver cancer
• Pediatric liver disease
• Liver Transplantation
• Genetic Liver Problems.
HOW TO PROTECT 
LIVER?
What is LIVER?
Liver is the largest organ in our body which performs many important 
functions including (a) metabolism of carbohydrate, protein and fat, (b) 
storing some nutrients, (c) converting fats to energy, (d) producing bile 
- a substance that helps the digestion and absorption of food, (e) 
protein synthesis, (f) helping the blood to clot, and (g) most 
importantly break down harmful substances including alcohol, and 
drugs in the blood.
How to protect our liver?
• Avoid alcohol
• Keep blood sugar & cholesterol under control
• Regular walking or exercise
• Maintain ideal body weight (Height in cm minus 100 = ideal body weight)
Example: If height is 160cm, ideal body weight will be 160 minus 100 = 60; 
that is 60kg)
• Get vaccine for Hepatitis B virus irrespective of age if not yet received
• Do screening check-up for liver disease minimum once in 5 years.
FATTY LIVER 
DISEASE
Fatty liver disease is a medical condition that is 
characterized by the accumulation of fat (called as 
steatosis) within the liver (i.e) fat droplets within 
hepatocytes. 
Risk factors for NAFLD:
• Diabetes mellitus
• Obesity / over weight
• Dyslipidemia (High cholesterol)
• Hypertension (High blood pressure)
• Hypothyroidism (Thyroid disease)
Management:
• Keep sugar / cholesterol level under control
• Maintain ideal body weight (Body mass index – 22 to 24)
• Less carbohydrate diet Eat a healthy diet
• Regular walking
HEPATITIS B HEPATITIS B&C
“Hepatitis” means inflammation of the liver. Whenever the liver is 
inflamed or damaged, it will lose its function. Hepatitis B virus is one 
of virus which will cause of serious liver disease over the period of 
time.
Acute Hepatitis B refers to a short-term infection that occurs within 
the first 6 months after someone is infected with the virus. It can 
range in severity from a mild illness with few or no symptoms to a 
serious condition requiring hospitalization. Some people, especially 
adults, are able to clear, or get rid of, the virus without treatment. 
People who clear the virus become immune and cannot get infected 
with theH eHpeaptaittiist isC B  viirus adgisaeina.se is a curable disease at initial 
stage. Similar to Hepatitis B virus, hepatitis C virus is one of 
the virus which will transmit through blood & blood 
products, unsafe sex and contaminated needles/ syringes, 
etc.
There is no evidence that kissing or hugging, sneezing or 
coughing, sharing food /water or through eating 
utensils/drinking glasses lead to transmission of hepatitis C 
virus
Acute versus chronic hepatitis C infection — when 
people are first infected with the hepatitis C virus, they 
develop acute hepatitis which mostly progress to chronic 
infection (i.e) virus will persist for more than 6 months.
LIVER CANCER
Hepatocellular carcinoma is the fourth common cause of cancer 
death in the World. It more common in men than in women. It also 
becomes more common with increasing age. There are other types 
of liver cancer include cholangiocarcinoma, which starts in the cells 
that line the bile duct, angiosarcoma (or haemangiosarcoma), 
which starts in the blood vessels of the liver, and hepatoblastoma 
which is very rare and usually affects young children.
Common symptoms:
• Unexplained weight loss, with or without back pain
• Loss of appetite Swelling of your upper abdomen (tummy)
• Feeling sick (Tiredness)
• Jaundice
Diagnosis & Severity assessment:
•Liver function test
•Alfa-feto protein
•CT abdomen with triphasic study / Whole body PET scan
•Gastroscopy
•HBsAg & Anti HCV
Management: Curative: Resection or Liver Transplantation
PEDIATRIC LIVER DISEASE
Biliary atresia
Normally, bile produced from the liver will drain into the intestine (duodenum) through 
the bile duct. Absence of the bile duct (i.e) developmental abnormality at birth itself is 
known as Biliary atresia. Hence, child will have persistence, progressive jaundice from 
2nd week of birth onwards.
Symptoms:
• Jaundice
• Pale coloured stool
• Failure to thrive
• Abdomen distension due to ascites (late stage)
What is jaundice?
 Jaundice (yellowish discolouration of eyes / skin) is one of symptom of the liver disease or damage. 
Most of   the liver diseases will cause jaundice. But sometimes, liver disease might occur and 
progress even without      jaundice.
LIVER TRANSPLANTATION
Now a days, liver transplantation is the most successful surgery (>90% 
survival) for medical therapy failed liver disease patients.
Indications for liver transplantation:
End Stage Liver Disease (ESLD) due to
1. Viral Hepatitis (HBV & HCV)
2. Alcoholic Liver Disease
3. NASH (Nonalcoholic steatohepatitis)
4. Cholestatic Liver Disease (Biliary atresia, PBC)
5. Metabolic Liver Disease (Ex: Wilson)
6. Autoimmune Liver Disease
7. Vascular Disease (BCS)
•Malignant Diseases of the liver – Hepatocellular carcinoma
•Acute Liver Failure (Infection, Toxin, Idiopathic)
Types of liver transplantation:
1.Deceased donor liver transplantation (DDLT)
2.Living donor liver transplantation (LDLT)
3.Split liver transplantation
4.Auxillary liver transplantation
5.Domino liver transplantation
6.Combined liver & kidney transplantation
7.Segmental liver transplantation
8.Swap liver transplantation
GENETIC LIVER PROBLEMS
THANK YOU