Dr. Chetan Kalal served as Organising Secretary of Grand Rounds in Hepatology 2026 — a Mid-Term Meeting of the Indian National Association for the Study of the Liver (INASL) — held 1st–3rd May 2026 at The St. Regis, Mumbai. Organising a national hepatology meeting is among the most demanding — and most significant — contributions a specialist can make to the medical community. The Organising Secretary is responsible for the scientific programme, faculty curation, session design, and the logistical execution of the entire conference. That Dr. Kalal chaired this role for the INASL Mid-Term Meeting reflects his standing at the centre of Indian hepatology — not on its periphery. Grand Rounds in Hepatology 2026 — Conference Overview Conference: Grand Rounds in Hepatology 2026 Type: Mid-Term Meeting of the Indian National Association for the Study of the Liver (INASL) Role: Organising Secretary — Dr. Chetan Kalal Dates: 1st–3rd May 2026 Venue: The St. Regis, Mumbai Theme: Clinical Dilemmas in Day-to-Day Hepatology Practice Organised by: Department of Hepatology About INASL — Indian National Association for the Study of the Liver INASL is India’s national hepatology society — the professional body for liver specialists across the country, affiliated with the International Association for the Study of the Liver (IASL). INASL organises the annual national conference (INASL Annual) and mid-term meetings that focus on specific clinical themes. The mid-term format typically concentrates on practical, case-driven, dilemma-based learning — the frontline clinical questions that the annual meeting cannot cover in depth. Being invited to organise an INASL Mid-Term Meeting — and specifically to chair its scientific structure as Organising Secretary — is one of the highest recognitions of expertise within the Indian hepatology community. Theme: Clinical Dilemmas in Day-to-Day Hepatology Practice The theme chosen for Grand Rounds in Hepatology 2026 is precisely what separates excellent hepatology from average hepatology: the dilemmas. Not the textbook cases with clear diagnoses and obvious treatment paths — but the real ones that arrive in clinic and in the emergency department: The cirrhotic patient with rising creatinine — HRS, pre-renal, intrinsic renal disease, or contrast nephropathy? The patient on immunosuppression with rising LFTs — rejection, CMV hepatitis, drug toxicity, or new autoimmune flare? The decompensated cirrhotic with ACLF Grade 2 — intensify medical management, list for transplant, or both simultaneously? The HCC nodule in a cirrhotic that doesn’t meet LI-RADS 5 criteria — biopsy, repeat imaging, or empirical treatment? The patient with AIH not responding to standard immunosuppression — inadequate dose, wrong diagnosis, or need for second-line therapy? Grand rounds as a format — real cases presented to a panel of experts for open discussion — is the oldest and most effective teaching method in clinical medicine. Applying it to hepatology at a national level, with curated clinical dilemmas drawn from daily practice across India, is exactly what the INASL Mid-Term format enables. The Organising Secretary shapes not just the logistics but the intellectual character of the meeting — which cases are presented, which faculty are invited to comment, which controversies are surfaced and debated. This is academic leadership, not administrative support. The St. Regis, Mumbai — Scientific Meeting at India’s Premier Venue The St. Regis Mumbai is among the most prestigious meeting venues in India — its selection reflects the calibre of the conference and the national importance of the INASL Mid-Term Meeting. Mumbai as the host city is significant: the financial capital of India, home to the highest concentration of private tertiary liver care centres in the country, and a hub for both domestic and international hepatology expertise. Dr. Chetan Kalal — Academic Leadership in Indian Hepatology The Grand Rounds in Hepatology 2026 Organising Secretary role represents the latest in a sustained record of academic leadership: Organising Secretary, Grand Rounds in Hepatology 2026 — INASL Mid-Term Meeting, The St. Regis Mumbai, 1–3 May 2026 Invited Faculty, LTSICON 2026 Midterm — Liver Transplant Society of India Conference, Pune — Case-Based Panel Discussion: Viral and Invasive Fungal Infection: Cause and Effect Relationship with Graft Dysfunction Invited Faculty, DRILLS 2026 — Decisions Reasoning Innovations & Learning in Liver DiseaseS, 7th Edition — ILBS, Pullman Aerocity, New Delhi, 13–14 June 2026 Invited Faculty, CRITICON 2026 — National Critical Care Conference Invited Faculty, LIVERCON 2026 — National Hepatology Conference APASL-AARC Consortium Member — contributing to ACLF criteria development and validation AASLD Foundation Young Investigator Award — 2016 and 2017 Fellow, National Academy of Medical Sciences (FNAMS) — 2022–23 Across 2026 alone, Dr. Kalal has been an organiser of one national meeting and faculty at four separate national and subspecialty conferences — a record of sustained engagement with the hepatology academic community that places him at its leadership tier. Clinical Dilemmas in Hepatology — Selected Topics The theme of Grand Rounds in Hepatology 2026 — clinical dilemmas in daily practice — maps directly onto Dr. Kalal’s clinical and research interests. Areas where dilemma-based hepatology teaching is most impactful include: ACLF: to transplant or not, and when ACLF Grade 2 and 3 present the most acute clinical dilemmas in hepatology. The window for successful LDLT in Grade 3 ACLF is 7–14 days — too early and the patient may recover medically; too late and operative risk becomes prohibitive. The decision requires real-time synthesis of AARC score trajectory, organ failure profile, donor availability, and patient and family readiness. No algorithm replaces experienced clinical judgment at this intersection. Antibiotics in cirrhosis — when, which, and how long Antibiotic stewardship in cirrhotic patients is a dilemma: these patients are highly susceptible to bacterial infections (which are the most common ACLF precipitant), but antibiotic overuse drives multi-drug resistant organism (MDRO) infections that are increasingly untreatable. The balance between empirical broad-spectrum coverage and judicious de-escalation guided by cultures is a daily clinical challenge in any busy liver unit. Renal function in cirrhosis — the creatinine trap Serum creatinine systematically underestimates the degree of renal impairment in cirrhotic patients because of reduced muscle mass (sarcopenia) and decreased hepatic creatinine production. A cirrhotic with creatinine 1.0 mg/dL may have a GFR