Dr. Jalil is a board-certified, fellowship-trained transplant hepatologist (liver doctor) and gastroenterologist at the Stanford Health Care Digestive Health Center in San Jose, California. He is also a clinical associate professor in the Department of Medicine, Division of Gastroenterology and Hepatology, at Stanford University School of Medicine.

Dr. Jalil has extensive experience helping patients with a range of liver- and digestion-related conditions. He specializes in liver transplantation, and his other clinical interests include all forms of hepatitis, cirrhosis of the liver, fatty liver disease, polycystic liver disease, and primary sclerosing cholangitis (swelling and scarring of the bile ducts). He has also volunteered in initiatives to offer free colonoscopy and hepatitis B screenings to underserved ethnic populations.

His research interests include improving mental health by enhancing treatment access for patients with alcohol use disorder causing alcoholic liver disease. He has also studied swallowing problems, liver disease in pregnancy, living liver donation, and the use of artificial intelligence in treating nonalcoholic fatty liver disease and viral hepatitis. In addition, Dr. Jalil wrote a chapter on bile secretion and cholestasis (diminished bile flow) for the fifth edition of Yamada’s Textbook of Gastroenterology.

Dr. Jalil has published in numerous peer-reviewed journals, including World Journal of Hepatology, Liver Transplantation, and the Journal of Clinical Gastroenterology. Additionally, he has served as a reviewer for Pancreatology and as an abstract reviewer for the American Gastroenterological Association (AGA) and the Ohio Chapter of the American College of Physicians. He has presented his research at meetings and conferences worldwide on a range of topics, including the timing of pregnancy after liver transplantation.

Dr. Jalil is an AGA fellow and a member of the American Association for the Study of Liver Diseases, American College of Gastroenterology, and American Society for Gastrointestinal Endoscopy.

Clinical Focus

  • Gastroenterology

Academic Appointments

Honors & Awards

  • Best Poster and Travel Award, American College of Gastroenterology
  • First Place, 2006 Annual Fellows Meeting, Texas Gulf Coast Gastroenterological Society
  • Educational Enrichment Award, Herzog Foundation
  • Presidential Poster Award, American College of Gastroenterology
  • June & Donald O. Castell, MD, Esophageal Clinical Research Award, American Gastroenterological Association

Professional Education

  • Board Certification: American Board of Internal Medicine, Internal Medicine (2018)
  • Board Certification: American Board of Internal Medicine, Transplant Hepatology (2010)
  • Board Certification: American Board of Internal Medicine, Gastroenterology (2007)
  • Fellowship: University of Texas Medical Branch Gastroenterology Fellowship (2007) TX
  • Fellowship: Integris Health Nazih Zuhdi Transplant Institute (2003) OK
  • Residency: University of North Dakota Internal Medicine Residency (1995) ND
  • Medical Education: Aga Khan University Medical College (1990) Pakistan

All Publications

  • Waitlist and posttransplant outcomes of pregnancy-related acute liver failure in the United States LIVER TRANSPLANTATION Jalil, S., Elfeki, M. A., Kiefer, M. K., Kuo, Y., Singal, A. K. 2023


    Data on the liver transplant (LT) outcomes of women with acute liver failure (ALF) due to liver diseases unique to pregnancy (P-ALF) are limited. Using United Network of Organ Sharing (UNOS) data (1987-2021), we analyzed waitlist and post-LT outcomes of ALF in women of childbearing age comparing P-ALF versus ALF due to liver diseases not unique to pregnancy. Baseline characteristics were compared between groups at the time of listing for LT. Of 3542 females aged 16-43 years and listed for LT for ALF, 84 (2%) listed for P-ALF were less likely to be Black (11 vs. 21%, p =0.033), have lower international normalized ratio (2.74 vs. 4.53 p <0.002), but more likely to have respiratory failure (56% vs. 41%, p <0.005), be on pressors (58% vs. 43%, p <0.005), and require dialysis (23% vs. 10%, p <0.001). The cumulative 90-day waitlist mortality (WLM) was lower in P-ALF vs. ALF due to liver diseases not unique to pregnancy (7.4 vs. 16.6%, p <0.001). Posttransplant survival rates at 5 years were similar (82% vs. 79%, p =0.89). In a Fine and Gray regression model controlled for listing year and Model for End-Stage Liver Disease score, 90-day WLM was lower in P-ALF with a sub-HR of 0.42 (95% CI: 0.19-0.94, p =0.035). Of 84 women with P-ALF and listed for LT, 45 listed for hemolysis-elevated liver enzymes-low platelets (HELLP) versus 39 for acute fatty liver of pregnancy had higher 90-day WLM (19.3% vs. 5.7% p <0.005). The 90-day WLM was about 10-fold higher in HELLP versus acute fatty liver of pregnancy with a sub-HR of 9.97 (95% CI: 1.64-60.55, p =0.013). In this UNOS database analysis of ALF among women of childbearing age, the waitlist outcome is better in women with P-ALF compared to women with ALF due to liver diseases not unique to pregnancy. Among women with P-ALF, the 90-day WLM is worse for HELLP versus acute fatty liver of pregnancy. Further studies are needed to improve the management of HELLP and prevent the development of ALF in this subgroup population.

    View details for DOI 10.1097/LVT.0000000000000319

    View details for Web of Science ID 001145483000001

    View details for PubMedID 38108820

  • Feasibility of single-session endoscopic ultrasound-guided liver biopsy and endoscopic retrograde cholangiopancreatography in liver transplant recipients with abnormal liver function tests CLINICAL ENDOSCOPY Han, S., Jalil, S., Groce, J. R., Krishna, S. G., Lee, P. J., Lara, L., Papachristou, G. I., Mumtaz, K. 2023; 56 (6): 823-826

    View details for DOI 10.5946/ce.2022.134

    View details for Web of Science ID 001110340700016

    View details for PubMedID 36941793

    View details for PubMedCentralID PMC10665621

  • WAITLIST AND POST-TRANSPLANT OUTCOMES OF PREGNANCY-RELATED ACUTE LIVER FAILURE IN THE US (1987-2021) Jalil, S., Elfeki, M. A., Arshad, M., Panneerselvam, D., Kuo, Y., Arab, J., Wong, R. J., Younossi, Z. M., Singal, A. K. LIPPINCOTT WILLIAMS & WILKINS. 2023: S1975-S1976
  • Outcomes of Nonvariceal Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A National Analysis. Journal of clinical gastroenterology Kruger, A. J., Abougergi, M. S., Jalil, S., Sobotka, L. A., Wellner, M. R., Porter, K. M., Conteh, L. F., Kelly, S. G., Mumtaz, K. 2023; 57 (8): 848-853


    We sought to evaluate hospital outcomes of cirrhosis patients with nonvariceal upper gastrointestinal bleeding (NVUGIB).NVUGIB is common in patients with cirrhosis. However, national outcome studies of these patients are lacking.We utilized the 2014 Nationwide Readmission Database to evaluate NVUGIB in patients with cirrhosis, further stratified as no cirrhosis (NC), compensated cirrhosis (CC), or decompensated cirrhosis (DC). Validated International Classification of Diseases, Ninth Revision, Clinical Modification codes captured diagnoses and interventions. Outcomes included 30-day readmission rates, index admission mortality rates, health care utilization, and predictors of readmission and mortality using multivariable regression analysis.Overall, 13,701 patients with cirrhosis were admitted with NVUGIB. The 30-day readmission rate was 20.8%. Patients with CC were more likely to undergo an esophagogastroduodenoscopy (EGD) within 1 calendar day of admission (74.1%) than patients with DC (67.9%) or NC (69.4%). Patients with DC had longer hospitalizations (4.1 d) and higher costs of care ($11,834). The index admission mortality rate was higher in patients with DC (6.2%) than in patients with CC (1.7%, P <0.001) or NC (1.4%, P <0.001). Predictors of 30-day readmission included performing an EGD >1 calendar day from admission (OR: 1.21; 95% CI, 1.00 to 1.46) and DC (OR: 1.78; 95% CI, 1.54 to 2.06). DC was a predictor of index admission mortality (OR: 3.68; 95% CI, 2.67 to 5.05).NVUGIB among patients with DC is associated with higher readmission rates, mortality rates, and health care utilization compared with patients with CC and NC. Early EGD is a modifiable variable associated with reduced readmission rates. Early identification of high-risk patients and adherence to guidelines may improve clinical outcomes.

    View details for DOI 10.1097/MCG.0000000000001746

    View details for PubMedID 35960536

  • Dilation balloon-occlusion technique for EUS-guided gastrojejunostomy. VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy Han, S., Groce, J. R., Jalil, S., Krishna, S. G., Lara, L. M., Lee, P. J., Shah, H., Papachristou, G. I. 2023; 8 (8): 313-315


    Video 1Dilation balloon-occlusion technique for EUS-guided gastrojejunostomy.

    View details for DOI 10.1016/j.vgie.2023.03.012

    View details for PubMedID 37575139

    View details for PubMedCentralID PMC10422050

  • Randomized intervention and outpatient follow-up lowers 30-d readmissions for patients with hepatic encephalopathy, decompensated cirrhosis. World journal of hepatology Pusateri, A., Litzenberg, K., Griffiths, C., Hayes, C., Gnyawali, B., Manious, M., Kelly, S. G., Conteh, L. F., Jalil, S., Nagaraja, H. N., Mumtaz, K. 2023; 15 (6): 826-840


    We previously reported national 30-d readmission rates of 27% in patients with decompensated cirrhosis (DC).To study prospective interventions to reduce early readmissions in DC at our tertiary center.Adults with DC admitted July 2019 to December 2020 were enrolled and randomized into the intervention (INT) or standard of care (SOC) arms. Weekly phone calls for a month were completed. In the INT arm, case managers ensured outpatient follow-up, paracentesis, and medication compliance. Thirty-day readmission rates and reasons were compared.Calculated sample size was not achieved due to coronavirus disease 2019; 240 patients were randomized into INT and SOC arms. 30-d readmission rate was 33.75%, 35.83% in the INT vs 31.67% in the SOC arm (P = 0.59). The top reason for 30-d readmission was hepatic encephalopathy (HE, 32.10%). There was a lower rate of 30-d readmissions for HE in the INT (21%) vs SOC arm (45%, P = 0.03). There were fewer 30-d readmissions in patients who attended early outpatient follow-up (n = 17, 23.61% vs n = 55, 76.39%, P = 0.04).Our 30-d readmission rate was higher than the national rate but reduced by interventions in patients with DC with HE and early outpatient follow-up. Development of interventions to reduce early readmission in patients with DC is needed.

    View details for DOI 10.4254/wjh.v15.i6.826

    View details for PubMedID 37397939

    View details for PubMedCentralID PMC10308285

  • Adverse Events With Esophageal Stenting: A Call to Optimize Device and Endoscopic Placement TECHNIQUES AND INNOVATIONS IN GASTROINTESTINAL ENDOSCOPY Ardeshna, D. R., Hussain, F. S., Balasubramanian, G., Papachristou, G. I., Lara, L. F., Groce, J., Han, S., Lee, P. J., Jalil, S., Hinton, A., Krishna, S. G. 2023; 25 (1): 11-20
  • Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma. World journal of gastroenterology Gnyawali, B., Pusateri, A., Nickerson, A., Jalil, S., Mumtaz, K. 2022; 28 (29): 3793-3802


    Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma (HCC). Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC, the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region. This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination, screening, and treatment in low-resource regions. Demographics including male gender, older age, ethnicity, and geographic location as well as low socioeconomic status are more heavily impacted by chronic hepatitis B and related HCC. Methods to mitigate this impact include increasing screening in high-risk groups according to national guidelines, increasing awareness and health literacy in vulnerable populations, and developing more robust vaccination programs in under-served regions.

    View details for DOI 10.3748/wjg.v28.i29.3793

    View details for PubMedID 36157533

    View details for PubMedCentralID PMC9367226

  • Emerging curative-intent minimally-invasive therapies for hepatocellular carcinoma. World journal of hepatology Zane, K. E., Nagib, P. B., Jalil, S., Mumtaz, K., Makary, M. S. 2022; 14 (5): 885-895


    Hepatocellular carcinoma (HCC) is the most common cause of liver malignancy and the fourth leading cause of cancer deaths universally. Cure can be achieved for early stage HCC, which is defined as 3 or fewer lesions less than or equal to 3 cm in the setting of Child-Pugh A or B and an ECOG of 0. Patients outside of these criteria who can be down-staged with loco-regional therapies to resection or liver transplantation (LT) also achieve curative outcomes. Traditionally, surgical resection, LT, and ablation are considered curative therapies for early HCC. However, results from recently conducted LEGACY study and DOSISPHERE trial demonstrate that transarterial radio-embolization has curative outcomes for early HCC, leading to its recent incorporation into the Barcelona clinic liver criteria guidelines for early HCC. This review is based on current evidence for curative-intent loco-regional therapies including radioembolization for early-stage HCC.

    View details for DOI 10.4254/wjh.v14.i5.885

    View details for PubMedID 35721283

    View details for PubMedCentralID PMC9157708

  • Call for action: Increased healthcare utilization with growing use of percutaneous cholecystectomy tube over initial cholecystectomy in cirrhotics. Hepatobiliary & pancreatic diseases international : HBPD INT Vedachalam, S., Jalil, S., Krishna, S. G., Porter, K., Li, N., Kelly, S. G., Conteh, L., Mumtaz, K. 2022; 21 (1): 56-62


    Acute calculous cholecystitis (ACC) is frequently seen in cirrhotics, with some being poor candidates for initial cholecystectomy. Instead, these patients may undergo percutaneous cholecystostomy tube (PCT) placement. We studied the healthcare utilization and predictors of cholecystectomy and PCT in patients with ACC.The National Database was queried to study all cirrhotics and non-cirrhotics with ACC between 2010-2014 who underwent initial PCT (with or without follow-up cholecystectomy) or cholecystectomy. Cirrhotic patients were divided into compensated and decompensated cirrhosis. Independent predictors and outcomes of initial PCT and failure to undergo subsequent cholecystectomy were studied.Out of 919 189 patients with ACC, 13 283 (1.4%) had cirrhosis. Among cirrhotics, cholecystectomy was performed in 12 790 (96.3%) and PCT in the remaining 493 (3.7%). PCT was more frequent in cirrhotics (3.7%) than in non-cirrhotics (1.4%). Multivariate analyses showed increased early readmissions [odds ratio (OR) = 2.12, 95% confidence interval (CI): 1.43-3.13, P < 0.001], length of stay (effect ratio = 1.39, 95% CI: 1.20-1.61, P < 0.001), calendar-year hospital cost (effect ratio = 1.34, 95% CI: 1.28-1.39, P < 0.001) and calendar-year mortality (hazard ratio = 1.89, 95% CI: 1.07-3.29, P = 0.030) in cirrhotics undergoing initial PCT compared to cholecystectomy. Decompensated cirrhosis (OR = 2.25, 95% CI: 1.67-3.03, P < 0.001) had the highest odds of getting initial PCT. Cirrhosis, regardless of compensated (OR = 0.56, 95% CI: 0.34-0.90, P = 0.020) or decompensated (OR = 0.28, 95% CI: 0.14-0.59, P < 0.001), reduced the chances of getting a subsequent cholecystectomy.Cirrhotic patients undergo fewer cholecystectomy incurring initial PCT instead. Moreover, the rates of follow-up cholecystectomy are lower in cirrhotics. Increased healthcare utilization is seen with initial PCT amongst cirrhotic patients. This situation reflects suboptimal management of ACC in cirrhotics and a call for action.

    View details for DOI 10.1016/j.hbpd.2021.07.008

    View details for PubMedID 34420884

  • Application of Artificial Intelligence in Non-alcoholic Fatty Liver Disease and Viral Hepatitis Artificial Intelligence in Gastroenterol Gunasekharan, A., Jiang, J., Nickerson, A., Jalil, S., Mumtaz, K. 2022
  • Trends and Health Care Outcomes Among Living Liver Donors: Are We Ready to Expand the Donor Pool With Living Liver Donations? Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Jalil, S., Black, S. M., Washburn, K., Rangwani, N., Hinton, A., Kelly, S. G., Conteh, L., Hanje, J., Michaels, A., Mumtaz, K. 2021; 27 (11): 1603-1612


    We studied the trends and various outcomes, including the readmission rates, health care utilization, and complications among living liver donors (LLDs) in the United States. We queried the National Database for data from 2010 to 2017 for all LLDs. The primary outcomes were 30-day and 90-day readmission rates. The secondary outcomes included health care use (length of stay [LOS], cost of care), index admission, and calendar-year mortality. Logistic regression models were fit for various outcomes. A total of 1316 LLDs underwent hepatectomy during the study period. The median donor age was 35.0 years (interquartile range, 27.4-43.6), and donors were predominantly women (54.2%). The trend of LLD surgeries remained stable at large medical centers (85.3%). The 30-day and 90-day readmission rates were low at 5% and 5.9%, respectively. Older age (50 years and older; 8%; confidence interval [CI], 0.6%-15.9%; P = 0.03) and hepatectomy at small to medium-sized hospitals were associated with increased index LOS (13.4%; 95% CI, 3.1%-24.7%; P = 0.01). Moreover, older age of donor (-11.3%; 95% CI, -20.3% to -1.4%; P = 0.03), Elixhauser score ≥3 (17%; 95% CI, 1.2%-35.3%; P = 0.03), and Medicaid insurance (24.5%; 95% CI, 1.2%-53.1%; P = 0.04) were also associated with increased cost. The overall rate of any complications during index admission was 42.8%. Male sex (odds ratio [OR], 1.63; 95% CI, 1.19-2.23) was an independent predictor of post-LLD complications. There was no index admission or calendar-year mortality reported during the study period. This is the largest national report of LLDs to date, showing that the trend of LLD surgeries is stable in the United States. With established safety, fewer complications, and less health care utilization, LLDs can be a potential source of continuation of liver transplantation in the context of changing liver allocation policies in the United States.

    View details for DOI 10.1002/lt.26223

    View details for PubMedID 34213813

  • Apprising the choice of bariatric surgery in patients with compensated cirrhosis with morbid obesity: results of a national analysis. Updates in surgery Miller, A., Jalil, S., Hussan, H., Kelly, S., Hinton, A., Hanje, J., Michaels, A., Conteh, L., Black, S., Mumtaz, K. 2021; 73 (5): 1899-1908


    Bariatric surgery (BS) was proved safe in carefully selected patients with compensated cirrhosis (CC). However, limited data exist on differential impact of bariatric surgery type on clinical outcomes and health care utilization. This retrospective study utilizes the 2010-2014 Nationwide Readmissions Database. We included obese adults with CC who underwent the two most commonly used BS, Roux-en-Y (RYGB) and laparoscopic sleeve gastrectomy (LSG). Those with decompensation within 6 months of BS were excluded. Rates of hepatic decompensation (new-onset ascites, variceal bleed, encephalopathy, spontaneous bacterial peritonitis, and/or hepatorenal syndrome), surgical complications, health care utilization, and mortality were compared between RYGB and LSG. Multivariable analysis was performed to fit various models. A total of 3032 patients with CC underwent BS, including 1864 (61.5%) RYGB and 1168 (38.5%) LSG. The majority (56%) of BS were performed at large, metropolitan teaching hospitals. There were no significant differences in various decompensations and surgical complications comparing RYGB to LSG. Healthcare utilization including index length of stay (RYGB: 3.4 days vs LSG: 3.0 days), 30-day readmission rate (RYGB: 9.5% vs LSG: 3.7%), and cost of admission (RYGB: $14,006 vs LSG: $12,523) were higher in RYGB (p values < 0.001). Index admission and calendar year mortality could not be analyzed due to the few number of events. Two types of bariatric surgeries in obese patients with compensated cirrhosis have similar rates of decompensated cirrhosis events and surgical complications. However, RYGB procedure incurred increased healthcare utilization. Therefore, LSG may be the preferred BS for patients with CC. Prospective, randomized studies comparing the types of BS are needed to confirm our observations.

    View details for DOI 10.1007/s13304-021-01142-z

    View details for PubMedID 34351576

  • Long Term Outcomes of TIPS for Patients With Refractory Variceal Bleeding and Ascites: "A Real World Experience" From a Single Large Center Jalil, S., Liu, A., Alexander, V., Rikabi, A., Makary, M., Pervez, R., Kelly, S. G., Conteh, L., Hinton, A., Michaels, A., Hanje, J., Mumtaz, K. LIPPINCOTT WILLIAMS & WILKINS. 2021: S516
  • ESOPHAGEAL STENT PLACEMENT FOR BENIGN ESOPHAGEAL INDICATIONS IS ASSOCIATED WITH HIGH RATES OF EARLY READMISSION Hussain, F. S., Balasubramanian, G., Hinton, A., Papachristou, G., Han, S., Runge, T. M., Groce, J. R., Jalil, S., Lara, L. F., Krishna, S. G. MOSBY-ELSEVIER. 2021: AB308
  • Dissecting novel mechanisms of hepatitis B virus-related hepatocellular carcinoma using meta-analysis of public data. Aljabban, J., Rohr, M., Syed, S. A., Cohen, E., Hashi, N., Syed, S., Khorfan, K., Boateng, E., Nemer, M., Panahiazar, M., Hadley, D., Jalil, S., Mumtaz, K., Aljabban, H. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Bariatric Surgery in Patients with Cirrhosis: Careful Patient and Surgery-Type Selection Is Key to Improving Outcomes. Obesity surgery Mumtaz, K., Lipshultz, H., Jalil, S., Porter, K., Li, N., Kelly, S. G., Conteh, L. F., Michaels, A., Hanje, J., Black, S., Hussan, H. 2020; 30 (9): 3444-3452


    Previous reports suggest an increased mortality in cirrhotic patients undergoing bariatric surgery (BS). With advancements in management of BS, we aim to study the trends, outcomes, and their predictors in patients with cirrhosis undergoing BS.A retrospective study was performed using the National Database from 2008 to 2013. Outcomes of BS in patients with cirrhosis were studied. In-hospital mortality, length of stay, and cost of care were compared between patients with no cirrhosis (NC), compensated cirrhosis (CC), and decompensated cirrhosis (DC). Multivariable logistic regression analysis was performed to study the predictors of mortality.Of the 558,017 admissions of patients who underwent BS during the study period, 3086 (0.55%) had CC and 103 (0.02%) had DC. An upward trend of vertical sleeve gastrectomy (VSG) utilization was seen during the study period. On multivariate analysis, mortality in CC was comparable with those in NC (aOR 1.88; CI 0.65-5.46); however, it was higher in DC (aOR 83.8; CI 19.3-363.8). Other predictors of mortality were older age (aOR 1.06; CI 1.04-1.08), male (aOR 2.59; CI 1.76-3.81), Medicare insurance (aOR 1.93; CI 1.24-3.01), lower income (aORs 0.44 to 0.55 for 2nd to 4th income quartile vs. 1st quartile), > 3 Elixhauser Comorbidity Index (aOR 5.30; CI 3.45-8.15), undergoing Roux-en-Y gastric bypass as opposed to VSG (aOR 3.90; CI 1.79-8.48), and centers performing < 50 BS per year (aOR 5.25; CI 3.38-8.15). Length of stay and hospital cost were also significantly higher in patients with cirrhosis as compared with those with NC.Patients with compensated cirrhosis can be considered for bariatric surgery. However, careful selection of patients, procedure type, and volume of surgical center is integral in improving outcomes and healthcare utilization in patients with cirrhosis undergoing BS.

    View details for DOI 10.1007/s11695-020-04583-4

    View details for PubMedID 32285332

  • A Rare Case of Hyperpigmentation of the Duodenum. The American journal of gastroenterology Imam, M. H., Peng, H., Jalil, S. 2016; 111 (1): 26

    View details for DOI 10.1038/ajg.2015.175

    View details for PubMedID 26785654

  • Challenges of hepatitis C treatment in Native Americans in two North Dakota medical facilities. Rural and remote health Hossain, S., Jalil, S., Guerrero, D. M., Sahmoun, A. E. 2014; 14 (3): 2982


    The prevalence of chronic liver disease (CLD) in the Aboriginal North American population is disproportionately higher than that of the non-indigenous population. Hepatitis C virus (HCV) is the second leading cause of CLD in American Indians or Alaska Natives (AIANs). This study described the experience of two teaching community medical centers in North Dakota in treating HCV infection among AIANs and compared treatment outcomes to a cohort of Caucasian patients.The retrospective study described the characteristics and proportion of AIAN patients with HCV who received treatment. Documented reasons for not receiving treatment were analyzed. For those AIAN patients treated for HCV infection, responses to treatment, including rapid, early and sustained virological responses (SVRs), were compared with those of Caucasians.Only 22 (18%) of 124 AIANs with HCV infection received treatment. Common reasons for not receiving treatment include lack of access to specialists, concomitant or decompensated liver disease, alcohol and drug abuse and cost. There were no significant differences in the baseline characteristics and key predictors of SVR in AIANs compared to Caucasian controls.Most AIAN patients with HCV infection do not receive treatment despite comparable treatment response rates to Caucasians. Further population-based studies, addressing access to specialized hepatitis C treatment and public health concerns are warranted, as it is crucial to treat chronic HCV infection to decrease the burden of disease in the AIAN community.

    View details for PubMedID 25238693

  • Antiviral therapy for recurrent hepatitis C reduces recurrence of hepatocellular carcinoma following liver transplantation. Transplant international : official journal of the European Society for Organ Transplantation Kohli, V., Singhal, A., Elliott, L., Jalil, S. 2012; 25 (2): 192-200


    Recurrence of hepatocellular carcinoma (HCC) is one of the major concerns following liver transplantation (LT). With the potential antitumor properties of interferon (IFN), their role in prevention of HCC recurrence is to be defined. We retrospectively reviewed 46 patients who underwent LT for hepatitis C virus (HCV)-related HCC between January 2004 and December 2008. Twenty-four (52.2%) patients with biopsy-proven HCV recurrence received antiviral therapy (IFN group); their outcomes were compared with 22 patients (control group). There was no significant difference for tumor size, number, and type of neo-adjuvant therapy between the two groups. The 1- and 3-year overall patient survival (100% vs. 90.9% and 87.3% vs. 71.8%; P = 0.150) and tumor-free survival (100% vs. 72.7% and 83.1% vs. 67.5%; P = 0.214) between IFN and control group were comparable. HCC recurrence was the most common cause of death (n = 6 of 12, 50%), all in the control group. During follow-up, seven (15.2%) patients developed HCC recurrence: one (4.1%) in the IFN group and six (27.3%) in the control group (P < 0.05). In conclusions, HCC recurrence rate and related deaths were significantly lower in patients that received post-transplant antiviral therapy for recurrent HCV.

    View details for DOI 10.1111/j.1432-2277.2011.01396.x

    View details for PubMedID 22151471

  • Chronic HBV with pregnancy: reactivation flare causing fulminant hepatic failure. Annals of hepatology Singhal, A., Kanagala, R., Jalil, S., Wright, H. I., Kohli, V. 2011; 10 (2): 233-6


    Chronic HBV infection is a dynamic state of interaction between HBV, hepatocytes, and the immune system of the host. A series of reactivation flares and remissions may occur due to multiple causes. Among them, spontaneous reactivation and immunosuppressive drugs including steroids or cancer chemotherapy are well known. This is due to immune-mediated destruction of HBV-expressing cells following withdrawal of immunosuppressive effect. Few cases have been reported in females during postpartum period. We report a case of fulminant hepatic failure during pregnancy in a previously unrecognized hepatitis B positive female requiring emergent liver transplantation.

    View details for PubMedID 21502688

  • Associations among behavior-related susceptibility factors in porphyria cutanea tarda. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Jalil, S., Grady, J. J., Lee, C., Anderson, K. E. 2010; 8 (3): 297-302, 302.e1


    Porphyria cutanea tarda (PCT) is the most common of the human porphyrias and results from an acquired deficiency of hepatic uroporphyrinogen decarboxylase (UROD). Some susceptibility factors have been identified; we examined associations among multiple factors in a large cohort of patients.Multiple known or suspected susceptibility factors and demographic and clinical features of 143 patients (mean age 52 years, 66% male, 88% Caucasian) with documented PCT (mean onset at 41 +/- 8.8 years) were tabulated; associations were examined by contingency tables, classification and regression tree (CART) analysis, and logistic regression.The most common susceptibility factors for PCT were ethanol use (87%), smoking (81%), chronic hepatitis C virus (HCV) infection (69%), and HFE mutations (53%; 6% C282Y/C282Y and 8% C282Y/H63D). Of those who underwent hepatic biopsy or ultrasound, 56% had evidence of hepatic steatosis. Of those with PCT, 66% of females took estrogen, 8% were diabetic, 13% had human immunodeficiency virus (HIV) infection, and 17% had inherited uroporphyrinogen decarboxylase (UROD) deficiency (determined by low erythrocyte UROD activity). Three or more susceptibility factors were identified in 70% of patients. HCV infection in patients with PCT was significantly associated with other behavior-related factors such as ethanol use (odds ratio [OR], 6.3) and smoking (OR, 11.9).Susceptibility factors for PCT were similar to previous studies; most patients had 3 or more susceptibility factors. Associations between PCT and HCV, ethanol or smoking could be accounted for by a history of multiple substance abuse; other factors are distributed more randomly among patients.

    View details for DOI 10.1016/j.cgh.2009.11.017

    View details for PubMedID 19948245

    View details for PubMedCentralID PMC2834813

  • EUS for portal hypertension: a comprehensive and critical appraisal of clinical and experimental indications ENDOSCOPY El-Saadany, M., Jalil, S., Irisawa, A., Shibukawa, G., Ohira, H., Bhutani, M. S. 2008; 40 (8): 690-696


    Endoscopic ultrasonography (EUS) has significantly improved our understanding of the complex vascular structural changes that occur in portal hypertension and their clinical and prognostic significance. EUS in combination with color Doppler technique enables us to study the hemodynamic changes in the portal venous system noninvasively, and to determine objectively the effect of different pharmacological agents on portal hypertension. EUS has also found some role in the treatment and follow up of esophageal and gastric varices. It may play a clinical role in the diagnosis of gastric, duodenal, and rectal varices. Recently reported EUS-based devices that measure variceal wall tension and intravariceal pressure noninvasively could have an impact on the identification of patients at high risk of variceal bleeding with the aim of initiating prophylactic treatment, and in the assessment of patients' responses to drug therapy of portal hypertension. EUS is occasionally very helpful in the clinical management of portal hypertension. It is an interesting and important research tool for many experimental indications that are not routinely applied in clinical practice at this time.

    View details for DOI 10.1055/s-2008-1077400

    View details for Web of Science ID 000258361600011

    View details for PubMedID 18609464

  • White bile (with video) GASTROINTESTINAL ENDOSCOPY Neilan, R. E., Groce, J. R., Jalil, S., Raju, G. S. 2007; 66 (1): 180-181

    View details for DOI 10.1016/j.gie.2006.12.025

    View details for Web of Science ID 000248056600037

    View details for PubMedID 17591495

  • Chronic HCV infection causes insulin resistance - a meta-analysis. Jalil, S., Mummadi, R. R., Sood, G. K. W B SAUNDERS CO-ELSEVIER INC. 2007: A784
  • Associations among susceptibility factors for human porphyria cutanea tarda Jalil, S., Grady, J. J., Anderson, K. E. W B SAUNDERS CO-ELSEVIER INC. 2007: A788
  • Acute Cholestatic Hepatitis Due To Clarithromycin: Complete Resolution Of A Usually Progressive Disease On Drug Withdrawal The Internet Journal of Gastroenterology Jalil, S., Shu-Yuan, X., Weinman, S. A. 2007
  • Nutritional effects of transjugular intrahepatic portosystemic shunt - An often neglected benefit? Rose, J. E., Gurakar, A. O., Duld, S., Camci, C., Parmalee, T., Nour, B., Sebastian, A. X., Kanoski, M., Wright, H. I., Rizvi, S. LIPPINCOTT WILLIAMS & WILKINS. 2006: S152-S153
  • Anal carcinoma with rectal mucosal involvement: The value of symptom initiated rectal examination Groce, J., Jalil, S., Nath, S., Scott, L. LIPPINCOTT WILLIAMS & WILKINS. 2006: S370
  • Endoscopic management of duodenal obstruction due to migrated biliary stents Jalil, S., Groce, J. R., Srinivasan, R., Gill, A. S., Kathuria, M., Raju, G. S. LIPPINCOTT WILLIAMS & WILKINS. 2006: S324
  • Liver ultrasound is not a good predictor of hepatic steatosis and fibrosis Jalil, S., Wood, A., Frachtman, S., Snyder, N., Soloway, R., Ernst, R., Cesani, F. LIPPINCOTT WILLIAMS & WILKINS. 2006: S170
  • Doppler ultrasound using standardized software is not useful for portal pressure measurement Jalil, S., Snyder, N., Soloway, R., Ozkan, O. S., Ernst, R., Oto, A. LIPPINCOTT WILLIAMS & WILKINS. 2006: S169-S170
  • Rectal varices masquerading as a mass Jalil, S., Soloway, R., Wong, R., Bhutani, M. S. BLACKWELL PUBLISHING. 2005: S191-S192
  • Drugs, Bugs or Cancer? A Case of Cholestatic Hepatitis American Journal of Gastroenterology Jalil, S., Xiao, S. Y., Weinman, S. A. 2005
  • Spontaneous rupture of liver in a non-pregnant patient: case report. journal of the Oklahoma State Medical Association Jalil, S., Gurakar, A., Sebastian, A., Bader, T., Wright, H., Stokes, K., Nour, B. 2004; 97 (6): 233-234


    Spontaneous rupture of the liver during pregnancy associated with preeclampsia is an uncommon and frequently fatal complication. A case of a 61-year-old non-pregnant female is described here who took estrogen replacement for 16 years and presented with spontaneous rupture of the right lobe of the liver with hemoperitoneum. The underlying cause of the rupture was not clear.

    View details for PubMedID 15346800

  • Effect of interval between swallows on oesophageal pressures and bolus movement in normal subjects - Studies with combined multichannel intraluminal impedance and oesophageal manometry NEUROGASTROENTEROLOGY AND MOTILITY Tutuian, R., Jalil, S., Katz, P. O., Castell, D. O. 2004; 16 (1): 23-29


    The effect of closely spaced swallows to decrease peristalsis ('deglutitive inhibition') is believed to be due to both central inhibitory impulses and smooth muscle refractoriness. Ten volunteers (three females, age 26-65) were given both four pairs and two series of four swallows at 5-, 10-, 15-s intervals and control swallows at 30-s intervals. Oesophageal function was assessed using combined multichannel intraluminal impedance and oesophageal manometry (MII-OM). Swallows were considered manometrical effective if distal oesophageal pressures >/=30 mmHg. Complete bolus transit was defined as bolus exiting from all three distal impedance segments. During swallowing at 5-s intervals the majority of initial swallows were ineffective with incomplete bolus transit while the last swallow in both series and pairs was manometrically effective with complete bolus transit. During swallowing at 10-15-s intervals the number of manometric ineffective swallows and swallows with incomplete bolus transit progressively increased with the number of swallows. The functional information obtained by MII-OM indicates pooling of liquid in the distal oesophagus that is cleared by the last swallow determined by, previously reported, neural inhibition occurring during swallowing spaced 5 s apart whereas incomplete bolus transit is related to manometrically ineffective swallows resulting from muscle refractoriness occurring during swallowing at 10-15-s intervals.

    View details for Web of Science ID 000188768100004

    View details for PubMedID 14764202

  • A liver transplant center experience with liver dialysis in the management of patients with fulminant hepatic failure: A preliminary report Joint Meeting of the Turkish-Transplantation-Society and Eurotransplant Aladag, M., Gurakar, A., Jalil, S., Wright, H., Alamian, S., Rashwan, S., Sebastian, A., Nour, B. ELSEVIER SCIENCE INC. 2004: 203–5


    Among extracorporeal liver support devices, liver dialysis is cleared by the U.S. Food and Drug Administration to be used for the management of fulminant hepatic failure (FHF). The outcomes of patients following liver dialysis need to be clearly evaluated. Among the 25 patients with FHF admitted to the Liver ICU between May 2000 and November 2002, 12 underwent liver dialysis, including 6 men and 6 women, of mean age 32 years. The causes of FHF were identified as acetaminophen (n = 10), herbal medications (n = 1) and autoimmune disease (n = 1). At presentation, the mean total bilirubin was 9.35 mg/dL (range, 0 to 1.3), mean ALT 3015 U/L (range, 0 to 48), mean AST 3457 (range, 0 to 42), mean ammonia 98 micromol/L (range, 10 to 60) and mean INR 1.88. A control group including 13 patients (2 men and 11 women), of mean age 27.8 years mean total bilirubin 5.66, mean ALT 3494, mean AST 3528, mean ammonia 113 and mean INR 3, were not treated with liver dialysis, due to the lack of machine availability or physician's choice. The causes of FHF were acute hepatitis B (n = 1), acetaminophen (n = 10) or unknown (n = 2). There was no statistically significant difference in the baseline characteristics of the two groups (P >.05). Among the liver dialysis group, 1 patient died, 2 underwent OLTx, and 9 were discharged home. Among the control group; 4 patients died, 2 underwent OLTx, and 7 were discharged home. Preliminary results seem to support survival benefit among patients who underwent liver dialysis compared to non-liver dialysis; however, further randomized control trials are warranted to verify this observation.

    View details for DOI 10.1016/j.tranproceed.2003.11.055

    View details for Web of Science ID 000188758100062

    View details for PubMedID 15013346

  • Are 10 Wet Swallows an Appropriate Sample of Esophageal Motility? Yes and No Journal of Clinical Gastroenterology Jalil, S., Sperandio, M., Tutuian, R., Castell, D. O. 2004
  • Gastric myoelectric changes during REM and Non-REM sleep in healthy volunteers Jalil, S., Randhawa, P., Khan, A., Goodrich, S., Orr, W. C. AMER ACADEMY SLEEP MEDICINE. 2003: A74
  • Low dose tacrolimus for the treatment of autoimmune hepatitis resistant to standard therapy Jalil, S., Gurakar, A., Wright, H., Bader, T., Sebastian, A., Nour, B. W B SAUNDERS CO. 2003: A785
  • Compatible ABO mismatch and liver transplantation: a single transplant center experience American Journal of Gastroenterology Aladaq , M., Jalil, S., Wright, H. I., et al 2003
  • Fulminant hepatitis A in patients with chronic liver disease-The importance of immunization revisited American Journal of Gastroenterology Jalil, S., Gurakar, A., Bader, T., Wright, H., Sebastian, T., Nour, B. 2003
  • Schatzki's ring - A benign cause of dysphagia in adults JOURNAL OF CLINICAL GASTROENTEROLOGY Jalil, S., Castell, D. O. 2002; 35 (4): 295-298


    The lower esophageal mucosal ring, or Schatzki's ring, was first described by Templeton. Anatomically, it represents the lower end of the esophagus. Patients classically present with intermittent dysphagia to solids. Diagnosis is made by endoscopy or a barium esophagram. Gastroesophageal reflux disease has been suggested as an etiology. It can usually be treated by passing a large dilator. Further controlled studies are needed to study its cause.

    View details for DOI 10.1097/01.MCG.0000028368.90843.4B

    View details for Web of Science ID 000178156500004

    View details for PubMedID 12352291

  • Evaluation of patients with achalasia using combined multichannel intraluminal impedance and esophageal manometry (MII/EM) Jalil, S., Tutuian, R. I., Jamison, S., Kong, L., Castell, D. O. ELSEVIER SCIENCE INC. 2002: S6
  • Evaluation of oropharyngeal dysphagia using combined multichannel intraluminal impedance & esophageal manometry (MII/EM) Jalil, S., Tutuian, R. I., Jamison, S., Kong, L., Castell, D. O. ELSEVIER SCIENCE INC. 2002: S9-S10
  • Effect of interval between swallows on esophageal pressures and bolus movement studied with combined multichannel intraluminal impedance and manometry (MII/EM) Tutuian, R. I., Jalil, S., Hila, A., Castell, J., Katz, P. O., Castell, D. O. W B SAUNDERS CO. 2002: A358
  • Bile Secretion and Cholestasis Textbook of Gastroenterology Jalil, S., Weinman, S. A. 2002
  • Meconium aspiration syndrome: the role of resuscitation and tracheal suction in prevention. Asia-Oceania journal of obstetrics and gynaecology Bhutta, Z. A., Jalil, S. 1992; 18 (1): 13-7


    We reviewed our experience of meconium staining of liquor and meconium aspiration syndrome over a 33 month period. The clinical and radiological severity of disease was assessed in comparison with tracheal suction and resuscitation. Sixty (27%) of newborns with meconium stained liquor subsequently developed MAS. No association was found between the thickness of meconium or its presence on tracheal aspiration with subsequent severity of respiratory disease. However, the presence of meconium in the trachea was strongly associated with radiological abnormality. The severity of meconium aspiration syndrome and mortality were also related to the clinical stability of the infants at presentation. Our results indicate that intrauterine aspiration and pulmonary maladaptation may play a significant role in meconium aspiration syndrome rather than resuscitative events at delivery.

    View details for DOI 10.1111/j.1447-0756.1992.tb00293.x

    View details for PubMedID 1627056