Gadour E, Kuriry H, Miutescu B, Raheem B, Gardezi SA, AlQahtani MS. Diagnostic and prognostic utility of serum bile acid in liver transplant recipients: A systematic review and quantitative synthesis. World J Hepatol 2026; 18(5): 119408 [DOI: 10.4254/wjh.v18.i5.119408]
Reader's ID:
08796784
Submitted on:
May 28, 2026, 14:56
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Reader Comments:
This systematic review by Gadour et al. provides a well-conducted and clinically valuable analysis of serum bile acid (SBA) as a biomarker in liver transplant recipients. Following PRISMA guidelines and using the QUIPS tool to assess study quality, the authors performed a rigorous quantitative synthesis, clearly demonstrating that elevated SBA is significantly associated with increased risks of early graft dysfunction, acute rejection, biliary complications, and poor long-term survival.
These findings are highly meaningful for clinical practice, as the study confirms that SBA outperforms conventional liver function tests in the early prediction of adverse post-transplant events, with the potential to refine surveillance strategies and enable timely intervention. The manuscript is well-structured, with clear presentation of results, appropriate use of biostatistics, and a balanced discussion of strengths and limitations.
While the study represents an important contribution to the field, some key points deserve consideration. Significant heterogeneity across included studies in SBA assay methods, detection time points, and cut-off values limits direct clinical standardization. Additionally, most analyses focused only on total SBA, and the prognostic roles of individual bile acid subtypes remain underexplored. Future large-scale, multicenter prospective studies are needed to address these gaps and validate the clinical utility of SBA monitoring.