Amrita Amyloid Centre

The Amrita Amyloid Center (AAC) is a dedicated, standalone multidisciplinary programme at Amrita Hospital, Kochi - the leading academic medical centre in Kerala and one of India's premier tertiary care hospitals. Launched in May 2023, the AAC brings together subspecialists across Cardiology, Hematology, Nephrology, Neurology, Gastroenterology, Rheumatology and Dermatology under one unified programme, ensuring that every patient with systemic amyloidosis receives coordinated, expert care from diagnosis through long-term management. The Centre is co-directed by Dr Hisham Ahamed (Cardiology) and Dr Neeraj Sidharthan (Hematology), and convenes a formal weekly Multidisciplinary Team (MDT) meeting, a standard of care rarely available for amyloidosis patients in South Asia. 

Diagnostic Workup

• Echocardiography & cardiac MRI
• Tc-PYP / DPD scintigraphy
• Comprehensive Hematological workup
• Endomyocardial & fat pad biopsy
• Congo red & immunofluorescence staining
• Mass spectrometry-based typing (LC-MS)

 Amyloid Typing & Staging

• ATTR vs AL differentiation 
• Genetic testing (Advanced Clinical Genomics Center) 
• Prognostic Staging 
• Organ involvement profiling

Treatment Programme

• Daratumumab-based regimens for AL 
• ASCT referral & coordination 
• Supportive & HF management 
• Multiorgan treatment co-ordination 
• Stabilizers for ATTR disease

Monitoring and Follow-up

• Serial biomarker surveillance(NT-proBNP, troponin, FLC) 
• Treatment response assessment 
• Cardiac function monitoring 
• Structured long-term follow-up 
• Advanced HF & palliative pathways 

Genetics and Family Screening 

• hATTR family cascade screening 
• Genetic counselling (Advanced Clinical Genomics Center)
•  Variant interpretation (ACMG-AMP) 
• Reproductive & predictive counselling
• Longitudinal surveillance for carriers 

Specialist Organ Clinics

• Nephrology Clinics 
• Neurology Clinics (Neuropathy) 
• Gastroenterology Clinics 
• Rheumatology & Dermatology Clinics 
• Integrated cross-specialty plans

Cardiac Imaging 

• Multiparametric cardiac MRI (T1 mapping, ECV, LGE) 
• Comprehensive echocardiography (2D, 3D, strain) 
• Tc-PYP / DPD bone scintigraphy (Perugini grading) 

• PET-MR 

  Tissue Pathology & Typing 

• Endomyocardial biopsy, abdominal fat pad & salivary gland 
• Gl and Renal biopsies 
• Congo red staining + polarised light microscopy 
• Immunohistochemistry (IHC) subtyping 

• Liquid chromatography-mass spectrometry (LC-MS) proteomics typing 

  Genomics & Biomarkers 

• TTR gene sequencing & variant interpretation 
• Full panel genomic testing (Advanced Clinical Genomics Center) 
• Serial NT-proBNP, cardiac troponin & serum FLC 
• Urine Bence Jones protein & immunofixation 
• Serum immunofixation and immunoyping 
• Bone marrow biopsy & plasma cell quantification

ATTR Amyloidosis 

• Tafamidis (TTR stabiliser) - wild-type & hereditary ATTR-CM 
• Supportive heart failure management 
• Device therapy (ICD, pacing) 
• Carpal tunnel syndrome management 

• Hereditary ATTR: family cascade evaluation & long-term surveillance

  AL Amyloidosis  

• Daratumumab-based combination regimens (real-world programme) 
• Standard & modified protocols for organ-compromised patients 
• ASCT referral and pre-transplant optimisation 
• Cardiac response monitoring (NT-proBNP, troponin) 
• Hematologic response tracking (dFLC, immunofixation) 
• Organ response assessment (renal, hepatic, neurologic) 

* Genetic testing for all heritable amyloidosis type is performed through the Advanced Clinical Genomics Centre at Amrita Hospital, Kochi 

• Amyloid Registry

Prospective registry capturing longitudinal data on ATTR and AL amyloidosis patients - the foundation of all AAC clinical research.

• Diagnostic Innovation

  Development and validation of novel diagnostic strategies, including a pilot in house ECG-echo risk score for AL amyloidosis and CMR-based prognostic tools.

• Genomics Research
  Characterising the genetic landscape of hereditary ATTR in South Asian populations; variant interpretation and family screening studies.
   
• LC-MS Proteomics
  Collaborative mass spectrometry based amyloid typing and characterization, enabling precise fibril-type identification beyond conventional histology.
   
• Treatment Outcomes
  
  Real-world outcomes research on daratumumab- based therapy and tafamidis, generating South Asian evidence therapeutic efficacy and outcome assessment
   

• International Collaboration

  Active collaborations with national and international centres, conference presentations, and peer-reviewed publications in leading haematology and cardiology journals.
   

• Dr Aparna Hari, PhD scholar of Amrita Amyloid Centre was awarded ISA Presidential Award on May 2024

• Referrals accepted from all specialties
• Patients can be referred on any day of the week
• No prior appointment required for urgent referrals
• Self-referral also accepted
• All amyloid types evaluated: ATTR (wild-type & hereditary), AL,SAA and rare forms
• Website referral form (coming soon)
  
  Contact the Co-Directors
   

• Dr Hisham Ahamed 

  [email protected] 

• Dr Neeraj Sidharthan 

  [email protected] 

• Extracellular Volume Mapping by Cardiac MRI Predicts Sudden Cardiac Death in AL Amyloidosis: A South Asian Cohort Study
  Pattnaik, Ahamed et al. · Indian J Hematol Blood Transfus (2025)
• Real-world outcomes of standard and modified daratumumab-based therapy in AL amyloidosis: A cohort study from a multidisciplinary program in south India
  Sidharthan, Chood OM et al. · Blood, Vol 146 Suppl 1 (2025)
• Diagnostic challenges in systemic light chain (AL) amyloidosis: A retrospective evaluation of biopsy yield and typing strategies in an Indian tertiary care centre
  Sidharthan, Meera M et al. · Blood, Vol 146 Suppl 1 (2025)
• Challenges in the Diagnosis and Treatment of AL Amyloidosis in a Resource-Limited Setting: A Retrospective Analysis at a Newly Established Amyloid Centre in India
  Pattnaik, Ahamed et al. · Blood, Vol 144 Suppl 1 (2024)
• Insights into systemic AL amyloidosis care in India: a retrospective analysis from the Amrita Amyloid Centre
  Hari, Krishnakumar et al. · Amyloid — Journal of Protein Folding Disorders (2024)
• An ECG-echo risk score for systemic light chain amyloidosis
  Hari, Krishnakumar et al. · Amyloid — Journal of Protein Folding Disorders (2024)