Liver Disease and Transplant Center

The Liver Disease and Transplant Center is the most prestigious liver disease facility in the Philippines. It offers the country's most comprehensive and most advanced range of facilities and services for the diagnosis and treatment of liver diseases.

The Center adopts a multidisciplinary approach and combines this with the state-of-the-art medical equipment of St. Luke's Medical Center. This synergy of cutting edge technology and topnotch liver specialists has given the Center its reputation of excellence in the detection, diagnosis, management and treatment of liver diseases which lead to improving survival of patients and improving their quality of life.

The Center is the Philippines’ leader in the field of Liver Cancer. It excels especially in performing Radiofrequency Ablation (RFA) of the liver, one of the latest technologies in the treatment or palliation of primary and metastatic liver tumors. RFA involves insertion of a probe through the liver tissue- guided by ultrasound or CT either percutaneously, laparoscopically, or through open surgery- into the tumor, and then the delivery of radiofrequency energy. Heat is generated at the site of the lesion, producing coagulation and cellular destruction (necrosis) resulting in the ablation of the target liver tissue. A relatively safe and well-tolerated procedure, RFA offers almost the same efficacy as surgery, but generally without the associated surgical risks and complications. The Center's record and experience in performing the procedure for both small and large lesions, to the extent of improving the survival even of some patients with huge tumors, make it the most reliable facility for liver RFA in the country today.

Another breakthrough technology in the Center for Liver Diseases is the Selective Internal Radiation Therapy or SIRT, a cutting-edge treatment for advanced liver cancer that utilizes new technologies to deliver radiation directly to the tumor. This new modality implants "beads" into the liver with cancer. And then slowly, through the months or through the years, the beads will emit some form of radiation. It has lesser side effects than the conventional radiotherapy because the normal organs within the tumor will not be hit.

The Liver Disease and Transplant Center is the leader in the Philippines in performing Adult-to-Adult Living-Donor Liver Transplantation. The Chief of Liver Transplantation Surgery, Dr. Allan Concejero, trained in Taiwan and has performed over 500 liver transplant surgeries. The other liver transplant surgery and microvascular surgery specialists on the team trained in various centers in the United States, Japan, Taiwan, and Singapore. The Transplant Hepatology team is headed by Dr. Juliet Gopez-Cervantes, who is also the Head of the Center, and who trained in Transplant Hepatology at the Starzl Transplant Institute of the Pittsburgh Medical Center and in Clinical and Interventional Hepatology at the Tohoku University Hospital in Japan. The other Transplant Hepatologist is Dr. Ian Homer Cua, who was trained in Taiwan, Australia and the New York Presbyterian Hospital.

Specific services include:

• Comprehensive, multidisciplinary approach to a variety of liver diseases Hepatology In-service: inpatient services dedicated to patients with liver diseases staffed by a team of hepatologists and nurse specialists.

• Multidisciplinary approach to the management of liver malignancies (primary or metastatic)

• Management of acute and chronic hepatitis of different etiologies with state-of-the-art medical therapies.

• Management of Liver Cirrhosis and its sequalae/complications

• Liver Transplantation

• Radiofrequency Ablation (RFA) – the latest established technology in the loco-regional treatment of primary and metastatic liver tumors that induces thermal form of treatment

• Molecular and Clinical research

• Active coordination with different local and international liver associations and foundations to promote programs in Hepatology for medical practitioners, patients and lay individuals.

I: State-of-the-art facilities for the complete diagnosis and management of liver diseases including:

• Viral hepatitis

• Primary sclerosing cholangitis

• Autoimmune liver disease (Autoimmune Hepatitis, Primary Biliary Cirrhosis)

• Alcoholic hepatitis

• Cirrhosis

• Hematochromatosis

• Non-alcoholic Steatohepatitis (NASH) Liver tumors, especially Hepatocellular Carcinoma, Cholangiocarcinoma and Metastatic Liver Disease

• Drug-induced hepatitis

• Hepato-Biliary tuberculosis

• Liver Abscess

• Polycystic Liver Disease

• Fulminant Hepatic Failure

II: Services

• Hepatology Inservice and outpatient services

• Liver Transplant Evaluation and Liver Transplantation

• Diagnostic & Therapeutic (interventional) services in the Liver

• Research

• Patient Education

• Screening and Prevention

III: Diagnostic Modalities:

• Ultrasound with Color Doppler Imaging/ Liver Mapping

• Real-time Shearwave Elastography

• Acoustic Radiation Force Imaging (ARFI) Elastography

• 256-Slice and 64-Slice CT (Four-Phased Dynamic CT of the Liver)

• Magnetic resonance imaging (MRI ) / Magnetic Resonance Cholangiopancreatography(MRCP) / Magnetic Resonance Angiogram (MRA) using Resovist Contrast

• Positron Emission Tomography–Computed Tomography (PET/CT)

• Endoscopic Retrograde Cholangiopancreatography (ERCP)

• X-ray

• Pathology (Basic, Molecular, Serology, Histopathology)

• Nuclear Medicine (Gamma Camera/Single-photon emission computed tomography (SPECT))

• PCR studies, genotyping, mutant strain determination

• Liver Biopsy (Percutaneous or Transjugular) with complete histopathological staining including special stains

• Hepatic Digital Subtraction Angiography with Portography/p>

• Video Endoscopy

• Paracentesis

IV: Therapeutic Modalities:

• Hepato-Biliary Surgery

• Radiofrequency Ablation (RFA)

• Percutaneous Ethanol Injection Therapy (PEIT)

• Transarterial Chemoembolization (TACE)

• Selective Internal Radiation Therapy (SIRT)

• Intensity Modulated Radiation Therapy (IMRT) with Respiratory Gating

• Percutaneous Aspiration/Drainage of huge liver abscess/hepatic cyst

• Sclerotherapy of giant hepatic cyst

• Chemotherapy/ Targeted Therapy

• Endoscopic Retrograde Cholangiopancreatography / Percutaneous Transhepatic Biliary Drainage (ERCP/ PTBD)

• Banding of Varices

• Transjugular Intrahepatic Portosystemic Shunt (TIPS)

• Paracentesis with or without pigtail catheter insertion

• Charcoal Hemoperfusion/Plasmapheresis for Acute Liver Failure

• Molecular Adsorbent Recirculating System (MARS) Liver Dialysis

• Liver Transplantation

V: Research Activities:

• A: Research Areas

  • Basic

  • Clinical

  • Genomic/Molecular

  • Diagnostic

  • Prognostic Markers

    • Viral Hepatitis

    • Liver Tumors (Primary & metastatic); Benign

    • Liver Cirrhosis

    • Acute liver failure

    • NASH (Non-alcoholic Steatohepatitis)

    • Alcoholic liver disease

    • Hepatoxicity, Inflammation and Fibrosis

    • Metabolism and Molecular Biology

    • Liver membrane transport and Cell Biology

    • Alpha Feto Protein serum/tissue and its specificity

    • Intensity-modulated Radiation Therapy (IMRT) with chemotherapy

    • Drug trials

    • Liver transplantation

    • Vaccine for Hepatitis C

• B: Data Banks

  • Liver Data Bank

  • Tumor Board/Liver Tumor Registry

VI: Clinical Areas:

• • Viral Hepatitis

• Cirrhosis

• Autoimmune Hepatitis

• Hepatocellular Carcinoma (Primary Liver Cancer)

• Metastatic Liver Cancer

• Fatty Liver

• Alcoholic Hepatitis

• Non-alcoholic Steatohepatitis (NASH)

• Genetic abnormalities

• Metabolic disorders in the Liver

• Drug induced liver injury

• Cholangitis

• Cholangiocarcinoma

• Hemochromatosis

• Wilson disease

• Other acute and chronic hepato-biliary diseases like Fulminant Hepatic Failure, infections like Liver Abscess, Schistosomiasis, Hepato-Biliary TB