Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Hepatol. May 27, 2026; 18(5): 119408
Published online May 27, 2026. doi: 10.4254/wjh.v18.i5.119408
Published online May 27, 2026. doi: 10.4254/wjh.v18.i5.119408
Diagnostic and prognostic utility of serum bile acid in liver transplant recipients: A systematic review and quantitative synthesis
Eyad Gadour, Hadi Kuriry, Mohammed S AlQahtani, Multiorgan Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
Eyad Gadour, Department of Internal Medicine, Faculty of Medicine, Zamzam University College, Khartoum 11113, Sudan
Bogdan Miutescu, Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania
Bogdan Miutescu, Advanced Regional Research Center of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania
Bodour Raheem, Department of Gastroenterology, King Salaman Medical City, Madinah 4235, Saudi Arabia
Syed A Gardezi, Department of Gastroenterology, Johns Hopkins healthcare Aramco, Dhahran 3224, Saudi Arabia
Mohammed S AlQahtani, Department of Surgery, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Author contributions: Gadour E, Miutescu B and AlQahtani MS conceptualized and designed the study, led the systematic review and quantitative synthesis, performed data analysis and interpretation, and drafted the manuscript; Kuriry H contributed to the literature search, data extraction, and manuscript editing; AlQahtani MS contributed to data collection, assisted with data analysis, and critically revised the manuscript for intellectual content; Miutescu B supported the study design, contributed to interpretation of results, and provided critical revisions; Raheem B contributed to data collection, assisted with data analysis, and critically revised the manuscript; Gardezi SA contributed to literature search, data extraction, and manuscript editing; all authors reviewed and approved the final version of the manuscript for publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Eyad Gadour, MD, MSc, CCST, Consultant MBBS, FACP, FRCP, MRCP, Professor, Multiorgan Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, Ammar Bin Thabit Street, Dammam 32253, Saudi Arabia. eyadgadour@doctors.org.uk
Received: January 27, 2026
Revised: February 13, 2026
Accepted: March 25, 2026
Published online: May 27, 2026
Processing time: 119 Days and 19 Hours
Revised: February 13, 2026
Accepted: March 25, 2026
Published online: May 27, 2026
Processing time: 119 Days and 19 Hours
Core Tip
Core Tip: Serum bile acid (SBA) levels serve as a sensitive, non-invasive biomarker for early detection and prognosis of graft dysfunction, acute rejection, patient survival, and biliary complications following liver transplantation. Elevated SBA levels correlate strongly with adverse outcomes, often preceding changes in conventional liver function tests. Despite promising diagnostic accuracy, heterogeneity in assay methods and cutoff values limits routine clinical use. Standardized protocols and large multicenter prospective studies are needed to validate SBA monitoring as a complementary tool to established biochemical tests, enhancing post-transplant surveillance and timely intervention strategies.