Recurrent Disease After Liver Transplantation

Liver transplantation is an effective treatment for many different types of acute and chronic liver disease. Many diseases recur following liver transplantation. This review provides an update in the latest clinical developments in recurrent disease after liver transplantation. Low-dose corticosteroids are associated with a reduction in recurrent autoimmune hepatitis following liver transplantation. “De novo” autoimmune hepatitis should be considered and treated as a form of allograft rejection. Tacrolimus has been reported to increase the risk of recurrent primary sclerosing cholangitis following liver transplantation. Autoimmune liver diseases such as primary biliary cholangitis, autoimmune hepatitis, and primary sclerosing cholangitis notably recur after transplant although the clinical significance of recurrent disease remains unclear. The clinical presentation, diagnosis, and management of recurrent autoimmune liver disease are variable and retransplantation is uncommonly needed. With the indications for liver transplantation constantly expanding, recurrence of original disease remains an important topic requiring further study.