Vishal C. Patel

Experience

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  Lewisham Healthcare NHS Trust

  Aug 2003 - Feb 2004

  Pre-registration House Officer - Gastroenterology / G(I)M
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  Guy's and St Thomas' NHS Foundation Trust

  Feb 2004 - Aug 2004

  • Pre-registration House Officer - Orthopaedics & Spinal Surgery

    May 2004 - Aug 2004

  • Pre-registration House Officer - General & Upper Gastrointestinal Surgery

    Feb 2004 - May 2004
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  Lewisham Healthcare NHS Trust

  Aug 2004 - Feb 2005

  Senior House Officer - Accident & Emergency
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  Newham University Hospital NHS Trust

  Feb 2005 - Aug 2005

  Senior House Officer - Gerontology & General Medicine
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  Homerton University Hospital Foundation Trust

  Aug 2005 - Aug 2006

  Senior House Officer - Rheumatology, Gastroenterology, Endocrinology & General Medicine
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  Barts Health NHS Trust

  Aug 2006 - Feb 2007

  Senior House Officer - HIV, Infection & Immunity
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  Princess Royal University Hospital NHS Trust

  Jan 2007 - Jan 2008

  Specialty Registrar (ST3) - Gastroenterology & General (Internal) Medicine
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  Lewisham Healthcare NHS Trust

  Feb 2007 - Aug 2007

  Senior House Officer - Intensive Care
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  Lewisham Healthcare NHS Trust

  Jan 2008 - Jan 2009

  Specialty Registrar (ST4) - Gastroenterology & General (Internal) Medicine
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  King's College Hospital NHS Foundation Trust

  Jan 2009 - Feb 2017

  Hepatology Doctoral Research Fellowship (King's College London):Institute of Liver Studies, King's College Hospital NHS Foundation TrustDivision of Transplantation Immunology & Mucosal BiologyChief Investigator: 'Gut Liver Axis in Liver Failure Syndromes and Liver Transplantation'> funded by Intensive Care Foundation New Investigator Award & KCH Liver ITU Research FundCollaborating institutions: > Dept of Hepatology at St Mary's Hospital, Imperial Healthcare Trust> Computational & Systems Medicine, Dept of Surgery & Cancer, Imperial College London> Dept of Pharmaceutical Sciences, King's College London> South Australian Health & Medical Research Institute Ltd. (SAMHRI), Adelaide, South Australia Lead Investigator: RIFSYS: 'Placebo controlled single centre double blind randomised trial to investigate the efficacy of Rifaximin versus placebo in improving systemic inflammation and neutrophil malfunction in patients with cirrhosis and chronic hepatic encephalopathy'- Investigator-Initiated Award funded: £420,000 - Additional £119,000 funding secured for ancillary IIS metagenomics study Ancillary research studies:> Monocyte dysfunction in acute-on-chronic liver failure (ACLF)> Coagulation dysfunction in chronic liver failure syndromes> High volume plasma exchange in acute liver failure (ALF)> Utility of breath ID in ALFClinical experience:> Tertiary Complex Hepatology> Liver Transplantation: pre-assessment and post-OLTx management > Liver Intensive Therapy including management of Acute/Subacute Liver Failure and ACLF> Diagnostic and Therapeutic Endoscopy including emergency management of complex and refractory variceal and non-portal hypertensive bleeding> JAG accredited for Upper and Lower GI endoscopy procedures> JAG accredited Upper and Lower GI endoscopy trainer Show less

  • Specialty Registrar (ST7) - Gastroenterology & General (Internal) Medicine

    May 2016 - Feb 2017

  • Doctoral Clinical Research Fellow - Institute of Liver Studies

    Jan 2011 - Apr 2016

  • Specialty Registrar (ST6) - Hepatology/Liver Transplantation/Liver ITU

    Jan 2010 - Jan 2011

  • Specialty Registrar (ST5) - Gastroenterology & General (Internal) Medicine

    Jan 2009 - Jan 2010
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  THE FOUNDATION FOR LIVER RESEARCH

  Jan 2018 - now

  Principal Investigator (Microbiome in ACLD Group)

  The research focus of my group is on the exposure of the cirrhotic liver to the dysbiotic gut microbiome and its pathogenic products and metabolites translocating from the gut lumen via a dysfunctional intestinal barrier. Gut dysbiosis is increasingly known to be causally linked to innate immune system dysfunction which in turn is proposed to have downstream effects including circulatory, renal, cerebral dysfunction and eventually multi-organ failure. Interrogation and modulation of the gut microbiome may therefore serve to provide insights into the patho-biological processes affecting the ‘gut-liver axis’ as well as prove to be a potential therapeutic target. Inextricably linked to this is the role of the intestinal barrier in cirrhosis, which is a challenge to study due to difficulties in accessing representative tissue and developing appropriate and physiologically reflective in vitro models.Characterisation of the gut microbiome – the composite of the genes that are harbored by these microorganisms and the environmental milieu within which they reside and interact - has been greatly improved by 16S ribosomal RNA and subsequent shotgun metagenomic sequencing as many of the gut bacteria are unculturable. The liver is crucial immunologically in challenging gut derived bacterial pathogen-associated molecular patterns (PAMPs) before entry into the systemic circulation, with 80% of the body’s resident macrophages residing in the liver to defend against invading bacteria. The liver is also a site of active local regulation of immune responses favoring induction of T-cell tolerance by the presence of a unique microenvironment rich in tolerogenic organ-resident cells, in part due to the constant exposure of the liver to gut-derived microbial organisms, their immunologically activating ligands and metabolites. Show less

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  King's College Hospital NHS Foundation Trust

  Aug 2018 - now

  - Chair monthly Liver RDU Research Governance Boards reviewing new studies, feasibility, performance and governance issues.- Assist in investigations of untoward events and ensuring the accurate and appropriate use of the Datix system for incident reporting.- Leading and generate enthusiasm to develop and grow clinical, translational and service research across the hospital:o Encourage and facilitate increased academic and commercial activityo Develop a research ethos throughout the service at all levelso Encourage and facilitate academic outputs within the RDU- Representing research at the relevant care group’s quality and risk meetings in order to strengthen feed-in of research governance in to Trust Risk Management structure.- Responsible and accountable for RDU Key Performance Indicators:o Study metrics within the RDU of recruitment and time to targeto Research activity (incorporating R&I Grants, NIHR funding, CRN income, uploading of recruitment data and commercial monies/activity)o Appropriate training is undertaken by research active staff (GCP, pharmacovigilance)- Collaborating with Trust R&I office in relation to governance issues, training, collation of information for internal and external reporting and escalation.- Actively participation in R&I Leads meetings bringing issues from the RDU and communicating trust issues back to the Care Groups as appropriate- Supporting the Trust R&I Directors and team in relevant working parties e.g. commercial strategy, Clinical Trials Office, NIHR, Bio-banking. Show less Management of patients with advanced chronic liver disease, including assessment for TIPSS, transplantation referral and diuretic intolerant ascites, portal hypertensive bleeding and refractory hepatic encephalopathy. Out-patient hepatology clinic and in-patient hepatology. Cirrhosis service development and network expansion.Endoscopic management of portal hypertension and therapeutic colonoscopy. JAG certified endoscopy trainer.Principal Investigator for several observational studies and interventional trials including: - Gut-Liver Axis in Liver Disease and Transplantation- ISAIAH trial (IL-1 Signal Inhibition in Alcoholic Hepatitis)- CAN-COVID (Study of Efficacy and Safety of Canakinumab Treatment for CRS in Participants With COVID-19-induced Pneumonia) Show less Trial name: Beta blockers Or Placebo for Primary Prophylaxis of oesophageal varices in cirrhosis (BOPPP). A triple blinded, multi-centre, clinical- and cost-effectiveness randomised controlled trial. Study design: Multi-centre, blinded, randomised controlled trial (RCT) of non-selective beta blockade (NSBB) vs placebo in patients with small oesophageal varices (OVs).Funder: National Institute of Health Research Health Technology Assessment programme: £2.2 million with additional £204k awarded (Variation to Contract)Setting: Secondary and tertiary care centres with endoscopy and gastro-hepatology services – 25 NHS hospital sites planned across the UK.Target population: Patients with cirrhosis and small OVs. Number of patients to be recruited: 740.Intervention: Placebo or carvedilol 6.25mg once daily dose adjusted to 12.5mg after a week if tolerated or if HR <50-55 bpm is reached. 1:1 randomisation ratio.Primary outcome: All-cause hepatic decompensation within 3 years, cost-effectiveness.Project timetable and recruitment rate: averaging 20/month since 15-month recruitment pause due to COVID19 pandemic. 640 recruited as of 16 Nov 2023.Chief Investigator: Dr. Vishal C. Patel(Consultant Hepatologist (KCH), Honorary Reader (KCL) & Principal Investigator (Institute of Hepatology, Foundation for Liver Research)Chief Scientific Investigator: Dr. Mark J. W. McPhail(Reader (KCL) & Honorary Consultant in Liver Critical Care & Hepatology(KCH))Lead Methodologist: Prof Ben Carter (Professor in Biostatistics, KCTU Mental Health Statistics Group Lead, KCL) Show less

  • Clinical Lead - Advanced Chronic Liver Disease

    Sept 2023 - now

  • Clinical Lead - Liver Research Delivery Unit

    Apr 2022 - now

  • Consultant Hepatologist & Endoscopist

    Jan 2018 - now

  • Chief Investigator: BOPPP RCT-NIHR HTA award £2.4 million

    Aug 2018 - now
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  King's College London

  Mar 2020 - now

  • Adjunct Reader in Hepatology

    Dec 2023 - now

  • Honorary Reader in Hepatology

    Jul 2023 - Dec 2023

  • Adjunct Senior Lecturer in Hepatology

    Mar 2020 - Jun 2023
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  Cleveland Clinic London

  May 2022 - now

  Consultant Hepatologist & Endoscopist

  Dr Vishal Patel is a Consultant Hepatologist and Endoscopist with experience in all aspects of liver disease, including abnormal liver function tests, hepatitis, fatty liver disease, autoimmune conditions, fibrosis and cirrhosis. Dr Patel's NHS base is within the Liver Unit at King's College Hospital where he looks after patients with advanced chronic liver disease and related complications. At Cleveland Clinic London Dr Patel works within the expert hepatology team to ensure patients receive the highest quality care, delivered in a welcoming and professional manner. He qualified from Guy’s & St Thomas’ Medical School and completed his specialist training in complex hepatology, liver intensive care and transplantation and interventional endoscopy at King's College Hospital. Dr Patel conducts translational research as a Principal Investigator with his laboratory based at the Roger Williams Institute of Hepatology. His lab group investigates the gut microbiome and cell-free DNA pathways in ACLD to better understand the condition and develop new treatments. He is Liver Research Lead at King's College Hospital and has secured National Institute for Health Research (NIHR) awarded funding to run one of the largest preventative liver trials in the U.K., as well as from the Intensive Care Society and Association of Physicians (U.K.). He continues to publish extensively contributing knowledge to the field and enjoys collaborating scientifically within the UK and globally. Show less