Liver transplantation is the second most common type of solid organ transplantation, after kidney transplantation (1, 2). (See also Overview of Transplantation.)
The most common indications for adult liver transplantation in the United States in 2023 include (3):
Alcohol-related cirrhosis: 34.6%
Metabolic dysfunction-associated steatohepatitis (MASH): 20.3%
Hepatocellular carcinoma: 10.4%
Cholestatic disease 7.4%
Alcohol-related hepatitis: 6.5%
Hepatitis C: 4.2%
Acute liver failure: 2%
Other/unknown: 14.7%
For comparison, the common indications for pediatric (3) liver transplantation differ significantly:
Cholestatic biliary atresia: 37.5%
Metabolic disorder: 14.8%
Acute liver failure: 8.1%
Hepatoblastoma: 8.1%
Other cholestatic disorder: 7.3%
Other/unknown: 24.3%
Complications of cirrhosis and portal hypertension that may necessitate liver transplantation include ascites, refractory gastric or variceal bleeding, encephalopathy, hepatopulmonary syndrome, portopulmonary hypertension, and synthetic dysfunction. In patients with cirrhosis, a Model for End-Stage Liver Disease (MELD) score ≥ 15 is a standard threshold for transplant evaluation. Additional indications for liver transplantation include systemic metabolic diseases primarily involving the liver such as alpha-1-antitrypsin deficiency, hemochromatosis, Wilson disease, glycogen storage disease, and familial amyloidosis, primary oxaluria (4).
For patients with hepatocellular carcinoma (HCC), transplantation is indicated for 1 tumor < 5 cm or up to 3 tumors < 3 cm. These criteria plus the absence of extrahepatic and major vessel involvement satisfy the Milan criteria, used to assess suitability of liver transplantation for patients who have cirrhosis and hepatocellular carcinoma (5). Several extended criteria sets (eg, UNOS downstaging criteria) are available to allow the downstaging of HCCs to within Milan criteria using various locoregional treatments, including transarterial chemo- or radioembolization, stereotactic radiation, or direct ablation via microwave or radiofrequency ablation (6).
For patients with liver metastases, transplantation is indicated only for neuroendocrine tumor or colorectal cancer without extrahepatic growth after removal of the primary tumor (7). Patients with intrahepatic cholangiocarcinoma, hepatic epithelioid hemangioendothelioma, or unresectable hepatic adenoma can candidates for liver transplantation in selected cases. (4, 8).
Contraindications to liver transplantation are (4):
Model for End-Stage Liver Disease (MELD) score < 15
Severe cardiac or pulmonary disease
Late-stage HIV
Ongoing alcohol use, illicit drug use, or inappropriate use of medications
Hepatocellular carcinoma with metastatic spread
Uncontrolled sepsis
Anatomic abnormality that precludes liver transplantation
Intrahepatic cholangiocarcinoma (early case can be the exception case for transplant as above)
Extrahepatic malignancy
Fulminant hepatic failure with sustained intracranial pressure > 50 mm Hg or cerebral perfusion pressure < 40 mm Hg
Hemangiosarcoma
Persistent nonadherence to recommended medical therapy
Lack of adequate social support system
All of these conditions lead to poor outcomes during or after transplantation.
Liver transplantation in patients with obesity, coronary artery disease, pulmonary hypertension, hepatopulmonary syndrome, or kidney dysfunction requires special consideration and multidisciplinary input (4). Patients with significant kidney dysfunction may be candidates for combined liver-kidney transplantation.
Liver donors
Most donated livers come after brain death, from size- and ABO-matched brain-dead (deceased), heart-beating donors (3). Prospective tissue typing and human leukocyte antigen (HLA) matching are not always required. ABO-incompatible liver transplants have been transplanted successfully in children < 2 years; in older children and adults, these transplants are not used because there is a high risk of rejection and bile duct damage (ductopenia) with cholestasis, which requires retransplantation.
Annually, more than 500 transplants in the United States come from living donors, who can live without their right lobe (in adult-to-adult transplantation) or the lateral segment of their left lobe (in adult-to-child transplantation) (3). Advantages of living donation for the recipient include shorter waiting times and shorter cold ischemic times for explanted organs, largely because transplantation can be scheduled to optimize the patient’s condition. Disadvantages to the donor include mortality risk of 1/1700 (compared with < 1/3300 in living-donor kidney transplantation) and complications (eg, bile leakage, bleeding) in up to one- fourth (9, 10). Clinicians must make every effort to prevent psychological coercion of donors.
A few livers come from deceased, non–heart-beating donors (called donation-after-cardiac-death [DCD] donors), but in such cases, bile duct complications develop in up to about one-third of recipients because the liver has been damaged by ischemia before donation (11, 12).
Donor (deceased or living) risk factors for graft failure in the recipient include (13, 14, 15, 16,, 17, 18):
Age > 40 (worsens with each increasing decade)
African-American race (versus White)
Shorter donor height
Cause of death other than trauma or anoxia
Partial or split organ, and donation after cardiac death
Longer cold ischemic time
Organ sharing outside of the local donor service area
Higher MELD score, especially bilirubin level
Hepatic steatosis
Elevated liver enzymes or bilirubin
Prolonged stay in an intensive care unit
Vasopressor use
Hypernatremia
However, because imbalance between supply and demand is greatest for liver transplants (and is growing because prevalence of hepatitis-induced cirrhosis is increasing), livers from donors > 40, livers with longer cold ischemia times, and those with viral hepatitis (for transplantation into recipients with viral hepatitis-induced cirrhosis) are increasingly being used.
Additional techniques to increase supply include:
Split liver transplantation: Deceased-donor livers are divided into right and left lobes or right lobe and left lateral segment (performed in or ex situ) and given to 2 recipients
Domino transplantation: Occasionally, a deceased-donor liver is given to a recipient with an infiltrative disease (eg, amyloidosis), and the explanted diseased liver is given to an older adult recipient who can benefit from the diseased liver but is not expected to live long enough to experience adverse effects of transplant dysfunction.
Despite these innovations, many patients die waiting for transplants (3). Liver-assist devices (extracorporeal perfusion of cultured hepatocyte suspensions or immortalized hepatoma cell lines) are used in some centers to keep patients alive until a liver is available or acute dysfunction resolves.
Organ distribution
For distribution of available organs, patients on the United States national waitlist are given a prognostic score derived from sex, serum sodium, creatinine, bilirubin, albumin, and international normalized ratio (INR) measurements (using the Model for End-Stage Liver Disease [MELD] 3.0 for patients ≥ 12 years old) (19) or from age, sex, serum albumin, bilirubin, INR, creatinine and CDC height/weight Z score (using the model for Pediatric End-Stage Liver Disease [PELD] for children < 12 years old) (20, 21). MELD 3.0 and PELD are formulas that are used to calculate the probability of a patient dying of liver disease while waiting for a liver transplantation. Patients more likely to die are given higher priority for organs from matched donors.
For patients with certain conditions, including hepatocellular carcinoma, hepatopulmonary syndrome, and cystic fibrosis, "exception points" are added to the MELD score to increase their priority for available organs.
General references
1. Schladt DP, Israni AK. OPTN/SRTR 2023 Annual Data Report: Introduction. Am J Transplant. 2025;25(2S1):S11-S21. doi:10.1016/j.ajt.2025.01.019
2. Rana A, Gruessner A, Agopian VG, et al. Survival benefit of solid-organ transplant in the United States. JAMA Surg. 2015;150(3):252-259. doi: 10.1001/jamasurg.2014.2038
3. Kwong AJ, Kim WR, Lake JR, et al. OPTN/SRTR 2023 Annual Data Report: Liver. Am J Transplant. 2025;25(2S1):S193-S287. doi:10.1016/j.ajt.2025.01.022
4. Martin P, DiMartini A, Feng S, et al. Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Hepatology. 2014;59(3):1144-1165. doi: 10.1002/hep.26972
5. Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
6. Tabrizian P, Holzner ML, Mehta N, et al. Ten-Year Outcomes of Liver Transplant and Downstaging for Hepatocellular Carcinoma. JAMA Surg. 2022;157(9):779-788. doi:10.1001/jamasurg.2022.2800
7. Clift AK, Hagness M, Lehmann K, et al. Transplantation for metastatic liver disease. J Hepatol. 2023;78(6):1137-1146. doi: 10.1016/j.jhep.2023.03.029
8. Frenette C, Mendiratta-Lala M, Salgia R, et al. ACG Clinical Guideline: Focal Liver Lesions. Am J Gastroenterol. 2024;119(7):1235-1271. doi: 10.14309/ajg.0000000000002857
9. Xiao J, Zeng RW, Lim WH, et al. The incidence of adverse outcome in donors after living donor liver transplantation: A meta-analysis of 60,829 donors. Liver Transpl. 2024;30(5):493-504. doi: 10.1097/LVT.0000000000000303
10. Lentine KL, Lam NN, Segev DL. Risks of Living Kidney Donation: Current State of Knowledge on Outcomes Important to Donors. Clin J Am Soc Nephrol. 2019;14(4):597-608. doi:10.2215/CJN.11220918
11. Ly M, Crawford M, Verran D. Biliary complications in donation after circulatory death liver transplantation: the Australian National Liver Transplantation Unit's experience. ANZ J Surg. 2021;91(3):445-450. doi:10.1111/ans.16304
12. Meier RPH, Kelly Y, Braun H, et al. Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study. Transpl Int. 2022;35:10855. Published 2022 Dec 9. doi:10.3389/ti.2022.10855
13. Cuende N, Miranda B, Canon JF, et al. Donor characteristics associated with liver graft survival. Transplantation. 2005;79(10):1445-1452. doi: 10.1097/01.tp.0000158877.74629.aa
14. Gambato M, Frigo AC, Rodriguez Castro KI, et al. Who fares worse after liver transplantation? Impact of donor and recipient variables on outcome: data from a prospective study. Transplantation. 2013;95(12):1528-1534. doi: 10.1097/TP.0b013e318292827f
15. Quillin RC 3rd, Wilson GC, Wima K, et al. Independent effect of black recipient race on short-term outcomes after liver transplantation. Surgery. 2015;157(4):774-784. doi:10.1016/j.surg.2014.10.018
16. Nair S, Eustace J, Thuluvath PJ. Effect of race on outcome of orthotopic liver transplantation: a cohort study. Lancet. 2002;359(9303):287-293. doi:10.1016/S0140-6736(02)07494-9
17. Briceño J, Ciria R, de la Mata M, et al. Prediction of graft dysfunction based on extended criteria donors in the model for end-stage liver disease score era. Transplantation. 2010;90(5):530-539. doi:10.1097/TP.0b013e3181e86b11
18. Zamboni F, Franchello A, David E, et al. Effect of macrovescicular steatosis and other donor and recipient characteristics on the outcome of liver transplantation. Clin Transplant. 2001;15(1):53-57. doi:10.1034/j.1399-0012.2001.150109.x
19. Kim WR, Mannalithara A, Heimbach JK, et al. MELD 3.0: The Model for End-Stage Liver Disease Updated for the Modern Era. Gastroenterology. 2021;161(6):1887-1895.e4. doi:10.1053/j.gastro.2021.08.050
20. Hsu E, Schladt DP, Wey A, et al. Improving the predictive ability of the pediatric end-stage liver disease score for young children awaiting liver transplant. Am J Transplant. 2021;21(1):222-228. doi: 10.1111/ajt.15925
21. OPTN Liver and Intestinal Organ Transplantation Committee. Notice of OPTN Policy and Guidance Changes Improving Liver Allocation: MELD, PELD, Status 1A, Status 1B. Accessed December 2, 2025.
Liver Transplantation Procedure
Deceased-donor livers are removed after exploratory laparotomy confirms absence of advanced or metastatic hepatocellular carcinoma, which would preclude transplantation. Living donors undergo lobar or segmental resection.
Explanted livers are perfused and stored in a cold preservation solution for up to 18 hours before transplantation; incidence of graft nonfunction and ischemic-type biliary injury increases with prolonged storage.
APHP-St ANTOINE-GARO/PHANIE/SCIENCE PHOTO LIBRARY
Recipient hepatectomy is the most demanding part of the procedure because it is often performed in patients with portal hypertension and coagulation defects. Intraoperative blood loss can total > 100 units in rare cases, but use of a cell saver machine and autotransfusion devices reduces allogeneic transfusion requirements to an average of 5 to 10 units. After hepatectomy, the suprahepatic vena cava of the donor graft is anastomosed to the recipient’s vena cava in an end-to-side fashion (piggy-back technique). Donor and recipient portal veins, hepatic arteries, and bile ducts are then anastomosed. With this technique, a bypass pump is not needed to carry portal venous blood to the systemic venous circuit. Heterotopic placement of the liver (not in its normal location) provides an auxiliary liver and obviates several technical difficulties, but outcomes appear to be inferior to orthotopic placement, and this technique is not widely used (1, 2).
Immunosuppressive regimens vary (see Posttransplant Immunosuppression. Basiliximab or thymoglobulin can be given as an induction on the day of transplantation, with a calcineurin inhibitor (cyclosporine or tacrolimus), mycophenolate mofetil, and glucocorticoids. Except in patients with autoimmune hepatitis, glucocorticoids can be tapered within weeks and often stopped after 3 to 4 months. Mammalian target of rapamycin (mTOR) inhibitors (sirolimus or everolimus) are sometimes used after a month post-transplantation as a kidney-sparing regimen or for patients with history of hepatocellular carcinoma. Compared with other solid organ transplantation, liver transplantation requires the lowest doses of immunosuppressants and requires glucocorticoids less frequently (. Basiliximab or thymoglobulin can be given as an induction on the day of transplantation, with a calcineurin inhibitor (cyclosporine or tacrolimus), mycophenolate mofetil, and glucocorticoids. Except in patients with autoimmune hepatitis, glucocorticoids can be tapered within weeks and often stopped after 3 to 4 months. Mammalian target of rapamycin (mTOR) inhibitors (sirolimus or everolimus) are sometimes used after a month post-transplantation as a kidney-sparing regimen or for patients with history of hepatocellular carcinoma. Compared with other solid organ transplantation, liver transplantation requires the lowest doses of immunosuppressants and requires glucocorticoids less frequently (3). Both induction and maintenance regimens vary by center.
Procedure references
1. de Rave S, Hansen BE, Groenland TH, et al. Heterotopic vs. orthotopic liver transplantation for chronic liver disease: a case-control comparison of short-term and long-term outcomes. Liver Transpl. 2005;11(4):396-401. doi: 10.1002/lt.20376
2. Blankensteijn JD, Schalm SW, Terpstra OT. New aspects of heterotopic liver transplantation. Transpl Int. 1992;5(1):43-50. doi: 10.1007/BF00337189
3. Na R, Laaksonen MA, Grulich AE, Webster AC, et al. Longitudinal dose and type of immunosuppression in a national cohort of Australian liver, heart, and lung transplant recipients, 1984-2006. Clin Transplant. 2015;29(11):978-990. doi: 10.1111/ctr.12617
Complications of Liver Transplantation
(See also Posttransplantation Complications.)
Rejection
Liver allografts are less aggressively rejected than other organ allografts for unknown reasons; hyperacute rejection occurs less frequently than expected in patients presensitized to HLA or ABO antigens (1), and immunosuppressants can often be tapered relatively quickly and eventually stopped (2). Most episodes of acute rejection are mild and self-limited, occur in the first 3 to 6 months, and do not affect graft survival.
Risk factors for rejection include (3, 4, 5):
Younger recipient age
Older donor age
ABO incompatibility
Greater HLA mismatching
Longer cold ischemia times
Autoimmune disorders
Worse nutritional status (eg, in alcohol use disorder) appears protective.
Symptoms and signs of rejection are nonspecific and usually recognized by abnormal liver function tests. The rejection could be confirmed with liver biopsy histology. (see table ).
Manifestations of Liver Transplant Rejection by Category
Rejection Category | Description |
|---|---|
Hyperacute rejection | Aggressive antibody-mediated injury immediately after ABO incompatible liver transplantation (very rare) |
Acute TCMR | Most frequent form. Usually within 3 months after transplantation. Late rejection can happen with the nonadherance to immune suppressants. Incidence up to 64% |
Acute AMR | Related to DSA which are either preformed or developed de novo after transplantation. Incidence less than 1% |
Chronic rejection | Usually from repeated undertreated TCMRs or a severe AMR Incidence 5% in adult recipients and 16% in pediatric recipients |
AMR = antibody-mediated rejection; DSA = donor-specific antibodies; TCMR = T-cell mediated rejection. Montano-Loza AJ, Rodríguez-Perálvarez ML, Pageaux GP, et al. Liver transplantation immunology: Immunosuppression, rejection, and immunomodulation. J Hepatol. 2023;78(6):1199-1215. doi:10.1016/j.jhep.2023.01.030 | |
Differential diagnosis of acute rejection includes viral hepatitis (eg, cytomegalovirus or Epstein-Barr virus infection; recurrent hepatitis B, C, or both), calcineurin inhibitor toxicity, and cholestasis.
Suspected T-cell mediated rejection can be treated with IV glucocorticoids; antithymocyte globulin is an option when glucocorticoids are ineffective. Antibody-mediated rejection can be treated with plasma exchange and/or intravenous immune globulin. B-cell depleting therapy with rituximab can be used.(Suspected T-cell mediated rejection can be treated with IV glucocorticoids; antithymocyte globulin is an option when glucocorticoids are ineffective. Antibody-mediated rejection can be treated with plasma exchange and/or intravenous immune globulin. B-cell depleting therapy with rituximab can be used.(6, 7). Retransplantation is tried when rejection is refractory to immunosuppressants and allograft failure develops (8).
Hepatitis recurrence after transplantation
For patients with untreated active hepatitis C prior to liver transplantation, or patients who received a hepatitis C-viremic organ, the patient can be treated with antiviral therapy within 2 weeks of liver transplantation. This approach has a near 100% sustained virologic response (9). Treatment depends upon previous treatment exposure, HCV genotypes, and presence of decompensated cirrhosis; for first line treatment, a pangenotypic regimen (glecaprevir-pibrentasvir or sofosbuvir-velpatasvir for 12 weeks) is recommended (). Treatment depends upon previous treatment exposure, HCV genotypes, and presence of decompensated cirrhosis; for first line treatment, a pangenotypic regimen (glecaprevir-pibrentasvir or sofosbuvir-velpatasvir for 12 weeks) is recommended (10).
Hepatitis B recurrence after liver transplantation is approximately 1% with prophylactic treatment(11).
Other complications
Early complications (within 2 months) of liver transplantation include (12, 13, 14):
Mechanical biliary dysfunction (eg, ischemic anastomotic strictures, bile leakage, ductal obstructions, leakage around T-tube site) (19% deceased donor, 31% living donor)
Hemorrhage requiring reoperation (14% deceased donor, 9% living donor)
Vascular complications, including portal vein and hepatic artery thrombosis (6% deceased donor, 9% living donor)
Primary nonfunction, in which the liver never functions and need to be replaced emergently (3 to 6%)
Hepatic artery mycotic aneurysm or pseudoaneurysm and hepatic artery rupture
Typically, symptoms and signs of early complications include fever, hypotension, and abnormal liver test results. Acute kidney injury is also very common in liver transplant recipients, affecting up to 50% of patients (14).
The most common late complicationcausing graft failure is (15):
Intrahepatic or anastomotic bile duct strictures, which cause symptoms of cholestasis and cholangitis
After liver transplantation with deceased donor grafts, strictures are particularly common, occurring in approximately one-fourth to one-third of recipients. Strictures can sometimes be treated endoscopically or using percutaneous transhepatic cholangiographic dilation, stenting, or both, but they often ultimately require retransplantation if allograft failure occurs.
Complications references
1. Knechtle SJ, Kwun J. Unique aspects of rejection and tolerance in liver transplantation. Semin Liver Dis. 2009;29(1):91-101. doi: 10.1055/s-0029-1192058
2. Lucey MR, Furuya KN, Foley DP. Liver Transplantation. N Engl J Med. 2023;389(20):1888-1900. doi: 10.1056/NEJMra2200923
3. Shindoh J, Akamatsu N, Tanaka T, et al. Risk factors for acute liver allograft rejection and their influences on treatment outcomes of rescue therapy in living donor liver transplantation. Clin Transplant. 2016;30(8):880-885. doi: 10.1111/ctr.12760
4. Tang LCY, Chetwood JD, Lai MSM, et al. Incidence, epidemiology, and outcomes of acute allograft rejection following liver transplantation in Australia. Liver Transpl. 2024;30(10):1039-1049. doi: 10.1097/LVT.0000000000000375
5. Wiesner RH, Demetris AJ, Belle SH, et al. Acute hepatic allograft rejection: incidence, risk factors, and impact on outcome. Hepatology. 1998;28(3):638-645. doi: 10.1002/hep.510280306
6. Dogan N, Husing-Kabar A, Schmidt HH, et al. Acute allograft rejection in liver transplant recipients: Incidence, risk factors, treatment success, and impact on graft failure. J Int Med Res. 2018;46(9):3979-3990. doi:10.1177/0300060518785543
7. Lee TY, Choi HJ, Seo CH, et al. Steroid-Resistant Rejection in Liver Transplant: A Single-Center Study for Risk Factor and Second-Line Treatment. Transplant Proc. 2022;54(2):443-449. doi: 10.1016/j.transproceed.2021.10.019
8. Montano-Loza AJ, Rodríguez-Perálvarez ML, Pageaux GP, et al. Liver transplantation immunology: Immunosuppression, rejection, and immunomodulation. J Hepatol. 2023;78(6):1199-1215. doi:10.1016/j.jhep.2023.01.030
9. Bhattacharya D, Aronsohn A, Price J, et al; AASLD-IDSA HCV Guidance Panel. Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clin Infect Dis. Published online May 25, 2023. doi: 10.1093/cid/ciad319
10. Bhattacharya D, Aronsohn A, Price J, Lo Re V; AASLD-IDSA HCV Guidance Panel. Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clin Infect Dis. Published online May 25, 2023. doi:10.1093/cid/ciad319
11. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800
12. Johnson SR, Alexopoulos S, Curry M, et al. Primary nonfunction (PNF) in the MELD Era: An SRTR database analysis. Am J Transplant. 2007;7(4):1003-1009. doi: 10.1111/j.1600-6143.2006.01702.x
13. Amara D, Parekh J, Sudan D, et al. Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience. Clin Transplant. 2022;36(6):e14610. doi: 10.1111/ctr.14610
14. Carrier FM, Trottier H, Soucy-Proulx M, et al. Risk factors for in-hospital postoperative complications and 6-month graft survival after liver transplantation: A multicenter cohort study. Liver Transpl. Published online July 18, 2025. doi: 10.1097/LVT.0000000000000684
15. Porrett PM, Hsu J, Shaked A. Late surgical complications following liver transplantation. Liver Transpl. 2009;15 Suppl 2:S12-S18. doi: 10.1002/lt.21893
Prognosis for Liver Transplantation
Among adult recipients of deceased donor liver transplants (1):
6 month graft failure rate: 6.3%, overall mortality 5.0%
1 year graft failure rate: 7.9%, overall mortality 6.5%
3 year graft failure rate 15.8%, overall mortality 14.0%
5 year graft failure rate: 20.7%, overall mortality 19.0%
10 year graft failure rate: 36.7%, overall mortality 34.6%
Among adult recipients of living donor liver transplants (overall mortality not reported for this group) (1):
6 month graft failure: 5.8%
1 year graft failure: 6.6%
3 year graft failure: 13.6%
5 year graft failure: 21.2%
10 year graft failure: 40.8%
Graft Survival is better for patients who received liver transplantation due to cholestatic liver disease or metabolic dysfunction-associated steatohepatitis (MASH) (1). Graft survival is worst in patients who received liver transplantation due to acute liver failure. Death after 1 year is usually attributable to a recurrent disorder (eg, cancer, metabolic dysfunction-associated steatohepatitis) rather than to posttransplantation complications.
Hepatic disorders with an autoimmune component (eg, primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis) recur in 10 to 53% of patients (2).
Prognosis references
1. Kwong AJ, Kim WR, Lake JR, et al. OPTN/SRTR 2023 Annual Data Report: Liver. Am J Transplant. 2025;25(2S1):S193-S287. doi:10.1016/j.ajt.2025.01.022
2. Te HS, Agopian VG, Demetris AJ, et al. AASLD AST Practice Guideline on Adult Liver Transplantation: Diagnosis and management of Graft-Related complications. Liver Transpl. Published online August 22, 2025. doi: 10.1097/LVT.0000000000000715
