About

Anjana A. Pillai, MD, is a board-certified gastroenterologist and transplant hepatologist specializing in managing chronic liver diseases, complex liver transplants, and hepatobiliary malignancies. She serves as the Medical Director of the Transplant Institute and the Adult Liver Transplant Program at the University of Chicago. As a professor of medicine and surgery, she is a full member of the University of Chicago Medicine Comprehensive Cancer Center, collaborating to provide individualized treatment options for her patients. Dr. Pillai leads the liver tumor program, overseeing a team of specialists focused on benign and malignant liver tumors to enhance patient care. She actively participates in national and international societies, including the UNOS National Liver Review Board and the International Liver Cancer Association, contributing to the advancement of research and industry standards. Additionally, she is the founder and course director of HCC-LIVE, an annual conference dedicated to liver cancer care, and holds leadership roles such as chairing the Liver Cancer Special Interest Group of the American Association for the Study of Liver Diseases.

Research topics

• Medicine
• Internal medicine
• Gastroenterology
• Surgery
• Political Science
• Immunology
• Public relations
• Demography
• Bioinformatics
• Engineering ethics
• Pathology
• Oncology
• Radiology
• Nuclear medicine
• Biology
• Microbiology
• Biochemistry

Selected publications

• H-1B Visa Changes and its Impact on Transplant Workforce

  Transplantation · 2026-01-15

  articleSenior author

  To the Editor: There is a shortage of trainees pursuing transplant fellowships across all solid organs.1 This led to the creation of the American Society of Transplantation Fellows Task Force who endorsed easing visa requirements for graduates that have trained outside the United States to fill in this gap.1 The J-1 and H-1B visas are commonly used by foreign medical graduates to permit their entry into the United States for medical training and continued employment. On September 19, 2025, a Presidential Proclamation was released2 requiring a $100 000 payment (Sec 1(a)) for new H-1B applications for those outside the United States, effective September 21, 2025, with expiration after 12 mo unless extended. Multiple US transplant fellowship programs (in addition to their prerequisite pipeline training programs) match foreign medical graduates requiring H-1B visas. Recent data show that transplant specialty fellowships have unfilled spots every year (e.g., 62% unfilled transplant hepatology spots in 2024)1 with a predicted 35% shortage of adult transplant hepatologists by 2033.1 The significant payment requirement for new H-1B visa applicants will worsen the strain on the workforce across all solid organ transplant fields including transplant surgery. This will likely have a negative impact on the ability to recruit trainees pursuing transplant fellowships across all organs and subsequently compromise patient care, delivery, and outcomes. Sec 1(c) of the proclamation2 does, however, permit an exception to the aforementioned payment if the Secretary of Homeland Security determines that “all aliens working in an industry…” (or on an individual or company basis) “…is in the national interest and does not pose a threat to the security or welfare of the United States.” Individuals who require an H-1B visa represent a critical component of the transplant workforce yet this new proclamation imposes administrative and financial barriers that threaten their ability to contribute to patient care and innovation in the United States. Given the strong bipartisan and bicameral presence of national medical and transplant-focused societies, they are uniquely positioned to lobby and engage with the Executive branch of the federal government to highlight the urgency of reducing visa-related obstacles and attempt to stabilize the transplant physician pipeline. Transplant-specific societies were not included on publicly available letters3 cosigned by other national medical societies sent to the federal government. This demonstrates a unique opportunity for transplant and supporting national medical societies to highlight how international trainees and physicians are critical to augment the work being done by US transplant physicians without replacing their efforts or compromising job availability. Another pathway would be for transplant societies to file an amicus brief as a part of current litigation (e.g., Chamber of Commerce of the United States of America v. United States Department of Homeland Security, 1:25-cv-03675 [D.D.C.]) to support clarity and discuss a targeted exemption for medical fields. Such efforts are essential to safeguard the current and future workforce and to meet the growing demand for high-quality transplant care nationwide. International mentees should also educate prospective fellows about evolving visa regulations and connect them with US programs experienced in visa sponsorship.

  PublisherDOI

• Impact of age on clinical outcomes among patients with hepatocellular carcinoma: A systematic review and meta-analysis

  JHEP Reports · 2025-02-26 · 6 citations

  reviewOpen access

  <h3>Background & Aims</h3> Older adults have lower treatment eligibility and worse survival across cancer types; however, the association between age and outcomes in patients with hepatocellular carcinoma (HCC) has not been well characterized. <h3>Methods</h3> We performed a search of the PubMed, Ovid MEDLINE, and EMBASE databases from January 2000 to July 2022 to identify studies reporting tumor stage, curative treatment, and overall survival among patients with HCC, stratified by age. Using the DerSimonian and Laird method for a random-effects model, we calculated pooled risk ratios (RRs) for curative treatment receipt and hazard ratios (HRs) for overall survival among younger and older patients (per age thresholds in each study). <h3>Results</h3> We identified 103 studies (n = 154,152 patients) that reported outcomes in younger <i>vs</i>. older patients with HCC. Younger patients were more likely to undergo curative treatment (RR 1.48, 95% CI 1.24–1.77; I² = 99%), although few studies reported treatment among those with early-stage HCC. Younger patients had better survival than older patients (HR 0.87, 95% CI 0.83–0.92; I² = 89%), which was consistent in subgroups using age thresholds of <70 years (HR 0.94, 95% CI 0.89–0.99; I² = 78%) and <75 years (HR 0.83, 95% CI 0.70–0.98; I² = 79%). Younger patients also had better survival in studies of patients with early-stage HCC (HR 0.78, 95% CI 0.65–0.94; I² = 60%) and those undergoing curative therapy (HR 0.87, 95% CI 0.77–0.98; I² = 87%). <h3>Conclusions</h3> Older patients with HCC are less likely to receive curative treatment and have worse survival than their younger counterparts. Studies to identify factors associated with worse prognosis can inform intervention targets. <h3>Impact and implications</h3> Older adults have worse survival across cancer types, although there are discordant data about the association between age and clinical outcomes in patients with hepatocellular carcinoma (HCC). Lower curative treatment receipt among older patients, despite similar early-stage presentation compared with younger patients, requires future studies to identify mediators that can inform intervention strategies that can increase curative treatment use. Worse survival observed among older patients appears to be primarily driven by non-liver-related mortality; however, few studies distinguish between liver and non-liver mortality. A better understanding of the prognostic value of comorbidity burden, in addition to age, can inform clinical decisions about stopping rules for HCC surveillance as well as the potential for HCC overdiagnosis and overtreatment.

  PublisherOA PDFDOI

• Reimagining Liver Cancer Allocation: Defining a New Vision

  Gastroenterology · 2025-01-04 · 1 citations

  editorialSenior author
  PublisherDOI

• Utilizing Artificial Intelligence to Predict Psychiatric Disorders in Patients with Inflammatory Bowel Disease (IBD): Insights Based on a Systematic Review

  European Psychiatry · 2025-04-01

  reviewOpen access1st author

  Introduction The scientific literature recognizes the Gut-brain axis (GBA) as a crucial connection between gastrointestinal health and mental well-being. Patients with inflammatory bowel disease (IBD) are at a disproportionately higher risk of developing psychiatric disorders due to factors including gut dysbiosis and chronic inflammatory changes. Recent developments in artificial intelligence (AI) and machine learning, provide novel opportunities to predict the comorbid psychiatric outcomes in patients with IBD by analyzing complex datasets including but not limited to the gut microbiome and neuroimaging data. Objectives This systematic review discusses the current evidence for AI-driven models to aid in the prediction of psychiatric disorders in IBD patients, with a focus on their performance and potential challenges around their clinical implementation. Methods A systematic search on PubMed, EMBASE, Scopus, and Cochrane databases, identified 28 studies utilizing AI-based models to examine gut microbiota and neuroimaging data in patients with IBD. Data extraction illuminated the following artifacts: classification thresholds (i.e. predictive), relevant supervised learning or deep learning modeling (e.g. random forest classifiers, convolutional neural networks, and unsupervised models like attention-based learning), sensitivity, specificity, accuracy, and both accuracy measures and AUC-ROC curve values. Results A pooled analysis of the included studies demonstrated an estimated sensitivity of 81% (95% CI: 77-85%) and specificity of 78% (95% CI: 73-82%) to predict psychiatric disorders in patients with IBD with the highest predictive accuracy elicited by studies based on microbiome and neuroimaging data. Yun et al. (2024), for instance, demonstrated a predictive accuracy of 86% using microbiome profiles and structural brain imaging data while Fil et al. (2024) elucidated the positive correlation between gut dysbiosis and psychiatric symptoms based on microbial signature models. Additionally, the variability noted in the predictive performance of the models was found to be based on the patient population, quality of data, and machine learning strategy. Conclusions AI models present promising evidence in predicting psychiatric disorders in IBD patients by leveraging microbiome and neuroimaging datasets. Overall, the meta-analysis reports strong predictive strength with high sensitivity and specificity. Future work in this field should focus on the validation of these prediction models in various clinical populations, improving their generalizability and standardization to enable widespread use and integration in the field of personalized psychiatry, especially in patients with IBD. Disclosure of Interest None Declared

  PublisherOA PDFDOI

• Variations in liver allocation systems across continents with a focus on MELD exceptions

  Liver Transplantation · 2025-10-16 · 1 citations

  articleOpen access

  Variations in liver allocation systems worldwide are presented, with a specific focus on regional differences and their potential impact on outcomes, with the goal of serving as a reference for future policy development. Summaries of liver allocation across multiple European, Scandinavian, and Asian systems, as well as the combined allocation system of Australia plus Canada, the United States, and the systems in Central America, South America, and the Caribbean are reviewed. A comprehensive comparison of how different regions address MELD exceptions, primarily focusing on hepatocellular carcinoma, along with the most common etiologies of liver disease requiring transplantation is presented. In addition, the adoption of living donation and donation after circulatory death is discussed. The study involves contributions from a diverse group of world experts in liver transplantation and may serve as an essential resource to foster international dialogue as countries strive to optimize organ allocation policies, including MELD exceptions.

  PublisherOA PDFDOI

• Combined liver with other solid organ transplants: Promises, pitfalls and ethical dilemmas

  Journal of Hepatology · 2025-04-30 · 4 citations

  reviewOpen access
  PublisherOA PDFDOI

• ACR Appropriateness Criteria® Staging and Follow-Up of Primary Liver Cancer

  Journal of the American College of Radiology · 2025-11-01 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• A systematic review assessing the efficacy of doxycycline as adjunct therapy for nodding syndrome

  European Psychiatry · 2025-04-01

  reviewOpen access

  Introduction The rare epileptic seizure syndrome nodding is endemic among African adolescents. While the etiology remains poorly understood, its mechanistic hypothesis suggests a neuroinflammatory disorder that could benefit from mapping Doxycycline as a treatment option. Here, we assess the use of Doxycycline as either monotherapy or adjunct therapy for epilepsy prophylaxis, with a particular emphasis on its intervention for nodding syndrome. Objectives The primary objective of this study is to assess the safety and efficacy of Doxycycline for treating nodding syndrome. Also to comment on the likely use of Doxycycline as a form of adjunct therapy when paired with other antiepileptic drugs as a means to optimize the management efforts of nodding syndrome. Methods Our analysis included randomized controlled trials and observational studies which were sorted and assessed in accordance to PRISMA guidelines through a systematic search of the literature using all electronic databases, including PubMed, Google Scholar, Scopus, and Cochrane. The search terms included Doxycycline and nodding syndrome. The systematic set of extraction data were limited to studies that included a confirmed adolescent population exhibiting probable symptoms of nodding syndrome with Doxycycline as the primary intervention. Effect sizes will be measured with a random-effects model, and heterogeneity will be calculated with I² statistics. Results Nine studies in total involving 1,120 subjects were analyzed, that included four randomized controlled trials (RCTs) assessing the effects of doxycycline monotherapy on 480 subjects, as well as five observational studies exploring the use of doxycycline with first-line anti-epileptic drugs (AEDs) on 640 subjects. Seizure frequency reduction Doxycycline administration on its own reduced seizure frequency by 30% relative to the placebo (relative risk [RR] = 0.70, 95% confidence interval [CI]= 0.60 to 0.85, p &lt; .001), whereas, added to AEDs, reduced seizure frequency by 45% (RR = 0.552, 95% CI = = 0.42 to 0.73, p &lt; 0.001; I² = 22%, considered low heterogeneity). Lower severity of symptoms The overall results suggest improvements in motor functions and cognitive assessments of -0.82 (standardized mean difference, 95% CI = -1.12 to -0.52, p &lt; .001), which may indicate an improvement in motor symptoms. AED add-on and impact on quality of life Doxycycline with AED smear resulted in a reduction in seizure frequency of 45% (SMD = -0.68, 95% CI = -0.94 to -0.42, p &lt; .001) and a statistically significant improvement in quality of life of approximately 25% (p &lt; 0.01); effect estimates presented moderate heterogeneity (I² = 45%). Conclusions Doxycycline has potential for extended use since our findings support a safe and potentially beneficial intervention in nodding syndrome. Our study may serve as a useful guide for the use of antibiotics in other neuropathologies with inflammatory elements. Disclosure of Interest None Declared

  PublisherOA PDFDOI

• The association between stage migration and overall survival after radiation-based therapies in patients with hepatocellular carcinoma

  JHEP Reports · 2025-05-07 · 1 citations

  articleOpen access

  <h2>Abstract</h2><h3>Background & Aims</h3> Stereotactic body radiation therapy (SBRT) and transarterial radioembolization (TARE) are common locoregional therapies for hepatocellular carcinoma (HCC). However, lack of surrogate endpoints has limited the feasibility of conducting comparative effectiveness clinical trials. <h3>Methods</h3> We conducted a multi-center retrospective cohort study of adult patients with HCC who received SBRT or TARE as initial treatment between 2008 and 2019. We excluded those with Barcelona Clinic Liver Cancer (BCLC) stage D disease. The primary outcome was overall survival, with transplantation as a competing risk. The independent variable of interest was stage migration to a more advanced BCLC stage (e.g., BCLC stage B → C) within 6 months of treatment. Survival analysis was completed using Kaplan-Meier, and multivariable Cox proportional hazard models was used to identify predictors of survival. <h3>Results</h3> We included 257 patients with a median age of 65 years; 77% male and 66% White. Most (75%) had Child-Pugh class A cirrhosis. Stage migration within 6 months was observed in 45 18%) patients. Patients who experienced stage migration within 6 months of receiving SBRT or TARE had significantly shorter survival than those without stage migration (median 192 days [IQR 108 – 397 days]) median versus 1259 days [IQR 591 – 2135 days], respectively; p<0.001). In multivariable analysis, stage migration was significantly associated with worse survival (HR 5.1 [95% CI: 4.3– 6.0]), however the correlation between stage migration and survival was not sufficient for surrogacy. The results were consistent in an independent external validation cohort and in relevant subgroup analyses. <h3>Conclusions</h3> Stage migration at 6 months is associated with overall survival in patients with HCC undergoing SBRT or TARE. <h3>Impact and Implications</h3> Stage migration in patients with receiving hepatocellular carcinoma (HCC) treatment is a multi-faceted measure of tumor function, functional status, and liver function. In this study we were able to show that worsening Barcelona Clinic Liver Cancer stage within 6 months of receipt of radiation treatment is associated with overall survival. Stage migration could be further explored as an endpoint in future clinical trials in patients with HCC receiving radiation therapies.

  PublisherOA PDFDOI

• Safety and Efficacy of Upadacitinib in Patients with Inflammatory Bowel Disease After Liver Transplantation: A Case Series

  Digestive Diseases and Sciences · 2025-11-20 · 1 citations

  articleOpen access

  PURPOSE: Approximately 2% of patients with inflammatory bowel disease (IBD) have primary sclerosing cholangitis (PSC), and some require liver transplantation (LT). Managing IBD after LT is challenging given concomitant anti-rejection immunotherapies. We report our experience using upadacitinib (UPA) to treat patients with IBD after LT. METHODS: Retrospective, single-center observational study at a tertiary center, identifying patients after LT who received UPA. We assessed efficacy and safety of UPA. RESULTS: Four patients after LT (Crohn's disease n = 3; ulcerative colitis n = 1) received UPA for IBD control (n = 3) or as a steroid-sparing adjunct for anti-rejection (n = 1), alongside anti-rejection immunosuppression. Median follow-up from UPA initiation was 10.5 months (IQR 8.9-14.6); age 41.5 years (IQR 40-44); interval from LT 3.2 years (IQR 2.3-5.6). Two receiving prednisone for Crohn's control at baseline achieved steroid-free remission (Harvey-Bradshaw Index < 5). Three developed liver enzyme elevation: one stopped UPA at one month with subsequent normalization of alanine and aspartate aminotransferase; one underwent liver biopsy showing no rejection and continued UPA with 9-month follow-up; and one receiving UPA for potential anti-organ rejection plus vedolizumab ultimately discontinued UPA for suspected rejection after tapering steroids. One patient experienced mild COVID-19 that resolved without treatment change. No life-threatening adverse events were observed. CONCLUSION: In this small series, UPA controlled IBD activity in 2 of 4 patients after LT but was associated with liver-enzyme elevations in 3, prompting discontinuation in 2. These findings support cautious, closely monitored use and highlight the need for a larger multi-center study of UPA in patients with IBD after LT.

  PublisherOA PDFDOI

Frequent coauthors

• Uqba Khan

  NewYork–Presbyterian Brooklyn Methodist Hospital

  48 shared

• David J. Pinato

  Imperial College London

  44 shared

• Antonio D’Alessio

  Università degli Studi del Piemonte Orientale “Amedeo Avogadro”

  41 shared

• Yi‐Hsiang Huang

  Taipei Veterans General Hospital

  38 shared

• Claudia Angela Maria Fulgenzi

  37 shared

• Lorenza Rimassa

  IRCCS Humanitas Research Hospital

  34 shared

• Alessio Cortellini

  33 shared

• Amit G. Singal

  31 shared

Education

• M.D.

  University of Miami School of Medicine

• Other, Internal Medicine

  University of Illinois Chicago

• Other, Gastroenterology and Hepatology

  Cleveland Clinic

• Other, Transplant Hepatology

  Northwestern Memorial Hospital