Role of biliary complications in chronic graft rejection after living donor liver transplantation

Abstract

Postoperative biliary complications remain a substantial challenge after living donor liver transplantation, especially due to its heterogeneous clinical presentation.

Keywords: Chronic graft rejection; Biliary complications; Living donor liver transplantation; Graft survival; Cholangiopathy

Core Tip: In clinical practice, post-transplant cholangiopathy is a multifactorial process, including not only biliary complications like biliary leakage, biliary infection and biliary stricture, idiopathic post-transplant chronic hepatitis, fibrosing cholestatic hepatitis, and viral infections like cytomegalovirus but also chronic graft rejection. The post-transplant cholangiopathy substantially influences graft, as well as patient outcome and survival. Therefore, it is of outmost importance to distinguish the underlying etiology while simultaneously appreciating the heterogeneous nature of post-transplant cholangiopathy. A better understanding of clinical and histopathological features can result in an improved therapy strategy.