Liver Disease is the one chronic disorder that's increasing in frequency with a steady rise in deaths each year.

Professor Roger Williams CBE

Dr Vishal C Patel

Principal Investigator 

Head of the Gut-liver Axis Group

Roger Williams Institute of Hepatology | Foundation for Liver Research

Consultant Hepatologist

The Liver Unit | King’s College Hospital | NHS Foundation Trust


Contact Dr Vishal Patel:

Twitter @DrVishalCPatel



Vishal Patel is a Consultant Hepatologist & Endoscopist at the Liver Unit, King’s College Hospital, focusing on Advanced Chronic Liver Disease (ACLD) and portal hypertension. He is a Principal Investigator and Group Lead for Microbiome in ACLD at the Roger Williams Institute of Hepatology, and Honorary Reader in Hepatology within the School of Immunology & Microbial Sciences at King’s College London. 


Dr Patel’s conducts clinical translational research with his lab group investigating two core themes:

The Patel group is focused on two key work-streams in advanced chronic liver disease:

The oral-gut-liver axis in ACLD:

  1. Characterising the changes that occur in the oral and gut micro-/mycobiome in ACLD by metagenomic sequencing
  2. Utilising novel markers to measure gut-derived bacterial translocation
  3. Assess the intestinal barrier in cirrhosis (inflammatory and immune characterisation)
  4. Profiling of microbiome generated metabolites e.g. plasma and faecal bile acids and by urinary NMR
  5. Rapid Infection Diagnostics in Cirrhosis (RIDiC) – being led by Dr Merianne Mohamed (Postdoctoral Researcher)

Coagulation pathways, organ dysfunction and role of cell-free DNA – being led by Marilena Stamouli (Research Associate):

  1. Cell-free DNA component profiling at various stages of ACLD
  2. Coagulation pathway interrogation (working with Prof Ton Lisman, Netherlands)
  3. Immuno-inflammatory interactions and pathways linking above
  4. Utilising epigenetic techniques to interrogate organ dysfunction

The above work is resourced by a combination of grants and funding from GUTS UK, Oxford Nanopore, Association of Physicians of Great Britain and Ireland, The Foundation for Liver Research, and the Intensive Care Society as well as King’s College Hospital Charity, and involves collaborations with research groups in London, UK, Denmark, Germany, Spain, Sweden, North America and Australia.


  1. In-depth shotgun metagenomic analysis of the oral and gut microbiome identifies striking overlaps in microbial community structure, virulence factors and antimicrobial resistance based on severity and stage of cirrhosis
  2. Evaluating the role of circulating cell-free DNA-mediated coagulation dysfunction, systemic inflammation, and organ injury in chronic liver failure syndromes
  3. Development and evaluation of point-of-care diagnostics utilising clinical metagenomic sequencing for rapid pathogen and antimicrobial resistance detection in decompensated cirrhosis and acute-on-chronic liver failure
  4. Beta-blockers Or Placebo for Primary Prophylaxis of oesophageal varices (BOPPP Trial). A blinded, UK multi-centre, clinical effectiveness and cost-effectiveness randomised controlled trial (NIHR funded £2.5 million) – Chief Investigator, sponsored by King’s College Hospital

Key Collaborators within the Institute:

  1. Shilpa Chokshi and Antonio Riva
  2. Jane Cox
  3. Anna Hadjichambi


Dr Merianne Mohamad | Postdoctoral scientist
Ms Marilena Stamouli | Research Assistant

Students and Visiting Fellows:

Dr Themoula Charalampous | Postdoctoral Research Scientist, Department of Infectious Diseases, King’s College London
Dr Veena Ramachandran | Clinical Research Fellow, Institute of Liver Studies, King’s College London
Aneesha Grewal | MBBS student, King’s College London

Key Publications:

Patel VC*, Lee S*, McPhail M, Da Silva K, Guilly S, Zamalloa A, Witherden E, Støy S, Manakkat Vijay GK, Pons N, Galleron N, Huang X, Gencer S, Coen M, Tranah TH, Wendon JA, Bruce K, Le Chatelier E, Ehrlich SD, Edwards LA, Shoaie S, Shawcross DL. Rifaximin reduces gut-derived inflammation and mucin degradation in cirrhosis and encephalopathy: RIFSYS randomised controlled trial. J Hepatol. 2021 Sep 24:S0168-8278(21)02040-7. doi: 10.1016/j.jhep.2021.09.010. Epub ahead of print. PMID: 34571050.

Ton Lisman, Bethlehem Arefaine, Jelle Adelmeijer, Ane Zamalloa, Eleanor Corcoran, John G Smith, William Bernal*, Vishal C Patel*. Global hemostatic status in patients with acute-on-chronic liver failure and septics without underlying liver disease. J Thromb Haemost. 2020 Oct 2. doi: 10.1111/jth.15112. (*indicates joint senior authorship)

Charlotte Woodhouse, Arjuna Singanayagam, Vishal C Patel. Modulating the gut–liver axis and the pivotal role of the faecal microbiome in cirrhosis. Clinical Medicine 2020 Sep; 20(5): 493–500. doi: 10.7861/clinmed.2020-0676

Antonio Riva∗, Elizabeth H. Gray∗, Sarah Azarian, Ane Zamalloa, Mark JW. McPhail, Royce P. Vincent, Roger Williams, Shilpa Chokshi, Vishal C. Patel#§, Lindsey A. Edwards§. Faecal cytokine profiling as a marker of intestinal inflammation in acutely decompensated cirrhosis. JHEP Rep. 2020 Dec;2(6):100151. doi: 10.1016/j.jhepr.2020.100151. Epub 2020 Jul 30 (*indicates joint first authorship, §indicates joint senior authorship, #corresponding author)

Patel, V.C., Williams, R. Antimicrobial resistance in chronic liver disease. Hepatol Int. 2020 Jan;14(1):24-34. doi: 10.1007/s12072-019-10004-1. Epub 2019 Dec 3. Review.

Annabel Blasi*, Vishal C. Patel*, Jelle Adelmeijer, Javier Fernández, William Bernal†, Ton Lisman†. Mixed fibrinolytic phenotypes in decompensated cirrhosis and ACLF with hypo fibrinolysis in those with poor outcome. Hepatology. 2020 Apr;71(4):1381-1390. doi: 10.1002/hep.30915. Epub 2019 Oct 24. (*indicates joint first authorship, †indicates joint senior authorship)



Web of Science:




More on Vish Patel’s research


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