PSC recurrence post liver transplantation: retransplantation justified or not?

Abstract

Post-liver transplant (LT), primary disease recurrence is a major cause of graft failure and long-term patient mortality (1). For decades, hepatitis C virus (HCV) recurrence was the number one cause of graft loss (2); however, with the development of potent anti-viral therapy, HCV transplant recipients no longer experience graft loss and death. In contrast, recurrence of autoimmune disease - particularly Primary Sclerosing Cholangitis (PSC) - remains a valid concern for the liver transplant community. This is despite an excellent short-term outcome post LT, with a survival rate above 90 % within the first year after transplant (3).