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Current Hepatology Reports

Erschienen in:

21.02.2020 | Portal Hypertension and Liver Transplantation (R Reddy, Section Editor)

Recurrent Disease After Liver Transplantation

verfasst von: Nicholas Lim, John Lake

Erschienen in: Current Hepatology Reports | Ausgabe 1/2020

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Abstract

Purpose of Review

Liver transplantation is an effective treatment for many different types of acute and chronic liver disease. Many diseases recur following liver transplantation. This review provides an update in the latest clinical developments in recurrent disease after liver transplantation.

Recent Findings

Low-dose corticosteroids are associated with a reduction in recurrent autoimmune hepatitis following liver transplantation. “De novo” autoimmune hepatitis should be considered and treated as a form of allograft rejection. Tacrolimus has been reported to increase the risk of recurrent primary sclerosing cholangitis following liver transplantation.

Summary

Autoimmune liver diseases such as primary biliary cholangitis, autoimmune hepatitis, and primary sclerosing cholangitis notably recur after transplant although the clinical significance of recurrent disease remains unclear. The clinical presentation, diagnosis, and management of recurrent autoimmune liver disease are variable and retransplantation is uncommonly needed. With the indications for liver transplantation constantly expanding, recurrence of original disease remains an important topic requiring further study.

Starzl TE, Marchioro TL, Vonkaulla KN, Hermann G, Brittain RS, Waddell WR. Homotransplantation of the liver in humans. Surg Gynecol Obstet. 1963;117:659–76.PubMedPubMedCentral

UNOS. 2017.

Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ, et al. Primary biliary cirrhosis. Hepatology. 2009;50(1):291–308.CrossRefPubMed

Carbone M, Neuberger JM. Autoimmune liver disease, autoimmunity and liver transplantation. J Hepatol. 2014;60(1):210–23.CrossRefPubMed

Davern TJ, Lake JR. Recurrent disease after liver transplantation. Semin Gastrointest Dis. 1998;9(3):86–109.PubMed

Gautam M, Cheruvattath R, Balan V. Recurrence of autoimmune liver disease after liver transplantation: a systematic review. Liver Transpl. 2006;12(12):1813–24.CrossRefPubMed

Liermann Garcia RF, Evangelista Garcia C, McMaster P, Neuberger J. Transplantation for primary biliary cirrhosis: retrospective analysis of 400 patients in a single center. Hepatology. 2001;33(1):22–7.CrossRefPubMed

Abu-elamgd A. Hepatology. 1997;26:176A.CrossRef

Neuberger J, Gunson B, Hubscher S, Nightingale P. Immunosuppression affects the rate of recurrent primary biliary cirrhosis after liver transplantation. Liver Transpl. 2004;10(4):488–91.CrossRefPubMed

10.

Levitsky J, Hart J, Cohen SM, Te HS. The effect of immunosuppressive regimens on the recurrence of primary biliary cirrhosis after liver transplantation. Liver Transpl. 2003;9(7):733–6.CrossRefPubMed

11.

Sanchez EQ, Levy MF, Goldstein RM, Fasola CG, Tillery GW, Netto GJ, et al. The changing clinical presentation of recurrent primary biliary cirrhosis after liver transplantation. Transplantation. 2003;76(11):1583–8.CrossRefPubMed

12.

Neuberger J. Recurrent primary biliary cirrhosis. Liver Transpl. 2003;9(6):539–46.CrossRefPubMed

13.

Hubscher SG, Elias E, Buckels JA, Mayer AD, McMaster P, Neuberger JM. Primary biliary cirrhosis. Histological evidence of disease recurrence after liver transplantation. J Hepatol. 1993;18(2):173–84.CrossRefPubMed

14.

Haagsma EB, Manns M, Klein R, Grond J, Huizenga JR, Slooff MJ, et al. Subtypes of antimitochondrial antibodies in primary biliary cirrhosis before and after orthotopic liver transplantation. Hepatology. 1987;7(1):129–33.CrossRefPubMed

15.

Dubel L, Farges O, Bismuth H, Sebagh M, Homberg JC, Johanet C. Kinetics of anti-M2 antibodies after liver transplantation for primary biliary cirrhosis. J Hepatol. 1995;23(6):674–80.CrossRefPubMed

16.

Lindor KD, Therneau TM, Jorgensen RA, Malinchoc M, Dickson ER. Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis. Gastroenterology. 1996;110(5):1515–8.CrossRefPubMed

17.

Lee J, Belanger A, Doucette JT, Stanca C, Friedman S, Bach N. Transplantation trends in primary biliary cirrhosis. Clin Gastroenterol Hepatol. 2007;5(11):1313–5.CrossRefPubMed

18.

Charatcharoenwitthaya P, Pimentel S, Talwalkar JA, Enders FT, Lindor KD, Krom RA, et al. Long-term survival and impact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantation. Liver Transpl. 2007;13(9):1236–45.CrossRefPubMed

19.

Nevens F, Andreone P, Mazzella G, Strasser SI, Bowlus C, Invernizzi P, et al. A placebo-controlled trial of obeticholic acid in primary biliary cholangitis. N Engl J Med. 2016;375(7):631–43.CrossRefPubMed

20.

Hirschfield GM, Mason A, Luketic V, Lindor K, Gordon SC, Mayo M, et al. Efficacy of obeticholic acid in patients with primary biliary cirrhosis and inadequate response to ursodeoxycholic acid. Gastroenterology. 2015;148(4):751–61.e8.CrossRefPubMed

21.

Seaberg EC, Belle SH, Beringer KC, Schivins JL, Detre KM. Liver transplantation in the United States from 1987-1998: updated results from the Pitt-UNOS Liver Transplant Registry. Clin Transpl. 1998:17–37.

22.

Reddy KR, Ellerbe C, Schilsky M, Stravitz RT, Fontana RJ, Durkalski V, et al. Determinants of outcome among patients with acute liver failure listed for liver transplantation in the United States. Liver Transpl. 2016;22(4):505–15.CrossRefPubMedPubMedCentral

23.

Neuberger J, Portmann B, Calne R, Williams R. Recurrence of autoimmune chronic active hepatitis following orthotopic liver grafting. Transplantation. 1984;37(4):363–5.CrossRefPubMed

24.

Wright HL, Bou-Abboud CF, Hassanein T, Block GD, Demetris AJ, Starzl TE, et al. Disease recurrence and rejection following liver transplantation for autoimmune chronic active liver disease. Transplantation. 1992;53(1):136–9.CrossRefPubMedPubMedCentral

25.

Sanchez-Urdazpal L, Czaja AJ, van Hoek B, Krom RA, Wiesner RH. Prognostic features and role of liver transplantation in severe corticosteroid-treated autoimmune chronic active hepatitis. Hepatology. 1992;15(2):215–21.CrossRefPubMed

26.

Duclos-Vallee JC, Sebagh M. Recurrence of autoimmune disease, primary sclerosing cholangitis, primary biliary cirrhosis, and autoimmune hepatitis after liver transplantation. Liver Transpl. 2009;15(Suppl 2):S25–34.CrossRefPubMed

27.

Manns MP, Czaja AJ, Gorham JD, Krawitt EL, Mieli-Vergani G, Vergani D, et al. Diagnosis and management of autoimmune hepatitis. Hepatology. 2010;51(6):2193–213.CrossRefPubMed

28.

Ayata G, Gordon FD, Lewis WD, Pomfret E, Pomposelli JJ, Jenkins RL, et al. Liver transplantation for autoimmune hepatitis: a long-term pathologic study. Hepatology. 2000;32(2):185–92.CrossRefPubMed

29.

Neumann UP, Guckelberger O, Langrehr JM, Lang M, Schmitz V, Theruvath T, et al. Impact of human leukocyte antigen matching in liver transplantation. Transplantation. 2003;75(1):132–7.CrossRefPubMed

30.

González-Koch A, Czaja AJ, Carpenter HA, Roberts SK, Charlton MR, Porayko MK, et al. Recurrent autoimmune hepatitis after orthotopic liver transplantation. Liver Transpl. 2001;7(4):302–10.CrossRefPubMed

31.

Montano-Loza AJ, Mason AL, Ma M, Bastiampillai RJ, Bain VG, Tandon P. Risk factors for recurrence of autoimmune hepatitis after liver transplantation. Liver Transpl. 2009;15(10):1254–61.CrossRefPubMed

32.

Milkiewicz P, Hubscher SG, Skiba G, Hathaway M, Elias E. Recurrence of autoimmune hepatitis after liver transplantation. Transplantation. 1999;68(2):253–6.CrossRefPubMed

33.

Prados E, Cuervas-Mons V, de la Mata M, Fraga E, Rimola A, Prieto M, et al. Outcome of autoimmune hepatitis after liver transplantation. Transplantation. 1998;66(12):1645–50.CrossRefPubMed

34.

Hübscher SG. Recurrent autoimmune hepatitis after liver transplantation: diagnostic criteria, risk factors, and outcome. Liver Transpl. 2001;7(4):285–91.CrossRefPubMed

35.

Molmenti EP, Netto GJ, Murray NG, Smith DM, Molmenti H, Crippin JS, et al. Incidence and recurrence of autoimmune/alloimmune hepatitis in liver transplant recipients. Liver Transpl. 2002;8(6):519–26.CrossRefPubMed

36.

Liberal R, Zen Y, Mieli-Vergani G, Vergani D. Liver transplantation and autoimmune liver diseases. Liver Transpl. 2013;19(10):1065–77.PubMed

37.

Ratziu V, Samuel D, Sebagh M, Farges O, Saliba F, Ichai P, et al. Long-term follow-up after liver transplantation for autoimmune hepatitis: evidence of recurrence of primary disease. J Hepatol. 1999;30(1):131–41.CrossRefPubMed

38.

Manns MP, Strassburg CP. Autoimmune hepatitis: clinical challenges. Gastroenterology. 2001;120(6):1502–17.CrossRefPubMed

39.

Murray-Lyon IM, Stern RB, Williams R. Controlled trial of prednisone and azathioprine in active chronic hepatitis. Lancet. 1973;1(7806):735–7.CrossRefPubMed

40.

Stellon AJ, Keating JJ, Johnson PJ, McFarlane IG, Williams R. Maintenance of remission in autoimmune chronic active hepatitis with azathioprine after corticosteroid withdrawal. Hepatology. 1988;8(4):781–4.CrossRefPubMed

41.

Krishnamoorthy TL, Miezynska-Kurtycz J, Hodson J, Gunson BK, Neuberger J, Milkiewicz P, et al. Longterm corticosteroid use after liver transplantation for autoimmune hepatitis is safe and associated with a lower incidence of recurrent disease. Liver Transpl. 2016;22(1):34–41.CrossRefPubMed

42.

Reich DJ, Fiel I, Guarrera JV, Emre S, Guy SR, Schwartz ME, et al. Liver transplantation for autoimmune hepatitis. Hepatology. 2000;32(4 Pt 1):693–700.CrossRefPubMed

43.

Kerkar N, Hadzić N, Davies ET, Portmann B, Donaldson PT, Rela M, et al. De-novo autoimmune hepatitis after liver transplantation. Lancet. 1998;351(9100):409–13.CrossRefPubMed

44.

Heneghan MA, Portmann BC, Norris SM, Williams R, Muiesan P, Rela M, et al. Graft dysfunction mimicking autoimmune hepatitis following liver transplantation in adults. Hepatology. 2001;34(3):464–70.CrossRefPubMed

45.

Demetris AJ, Bellamy C, Hübscher SG, O'Leary J, Randhawa PS, Feng S, et al. Comprehensive update of the Banff working group on liver allograft pathology: introduction of antibody-mediated rejection. Am J Transplant. 2016;16(10):2816–35.

46.

Andries S, Casamayou L, Sempoux C, Burlet M, Reding R, Bernard Otte J, et al. Posttransplant immune hepatitis in pediatric liver transplant recipients: incidence and maintenance therapy with azathioprine. Transplantation. 2001;72(2):267–72.CrossRefPubMed

47.

Salcedo M, Vaquero J, Bañares R, Rodríguez-Mahou M, Alvarez E, Vicario JL, et al. Response to steroids in de novo autoimmune hepatitis after liver transplantation. Hepatology. 2002;35(2):349–56.CrossRefPubMed

48.

Miyagawa-Hayashino A, Haga H, Egawa H, Hayashino Y, Sakurai T, Minamiguchi S, et al. Outcome and risk factors of de novo autoimmune hepatitis in living-donor liver transplantation. Transplantation. 2004;78(1):128–35.CrossRefPubMed

49.

Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, et al. Diagnosis and management of primary sclerosing cholangitis. Hepatology. 2010;51(2):660–78.CrossRefPubMed

50.

Goss JA, Shackleton CR, Farmer DG, Arnaout WS, Seu P, Markowitz JS, et al. Orthotopic liver transplantation for primary sclerosing cholangitis. A 12-year single center experience. Ann Surg. 1997;225(5):472–81 discussion 81–3.CrossRefPubMedPubMedCentral

51.

Narumi S, Roberts JP, Emond JC, Lake J, Ascher NL. Liver transplantation for sclerosing cholangitis. Hepatology. 1995;22(2):451–7.CrossRefPubMed

52.

Document UP. 2016.

53.

Gores GJ, Gish RG, Sudan D, Rosen CB, Group MES. Model for end-stage liver disease (MELD) exception for cholangiocarcinoma or biliary dysplasia. Liver Transpl. 2006;12(12 Suppl 3):S95–7.CrossRefPubMed

54.

Rea DJ, Heimbach JK, Rosen CB, Haddock MG, Alberts SR, Kremers WK, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg. 2005;242(3):451–8 discussion 8–61.PubMedPubMedCentral

55.

Graziadei IW, Wiesner RH, Marotta PJ, Porayko MK, Hay JE, Charlton MR, et al. Long-term results of patients undergoing liver transplantation for primary sclerosing cholangitis. Hepatology. 1999;30(5):1121–7.CrossRefPubMed

56.

Andersen IM, Fosby B, Boberg KM, Clausen OP, Jebsen P, Melum E, et al. Indications and outcomes in liver transplantation in patients with primary sclerosing cholangitis in Norway. Transplant Direct. 2015;1(9):e39.CrossRefPubMedPubMedCentral

57.

Lerut J, Demetris AJ, Stieber AC, Marsh JW, Gordon RD, Esquivel CO, et al. Intrahepatic bile duct strictures after human orthotopic liver transplantation. Recurrence of primary sclerosing cholangitis or unusual presentation of allograft rejection? Transpl Int. 1988;1(3):127–30.CrossRefPubMed

58.

Sheng R, Zajko AB, Campbell WL, Abu-Elmagd K. Biliary strictures in hepatic transplants: prevalence and types in patients with primary sclerosing cholangitis vs those with other liver diseases. AJR Am J Roentgenol. 1993;161(2):297–300.CrossRefPubMed

59.

Sheng R, Campbell WL, Zajko AB, Baron RL. Cholangiographic features of biliary strictures after liver transplantation for primary sclerosing cholangitis: evidence of recurrent disease. AJR Am J Roentgenol. 1996;166(5):1109–13.CrossRefPubMed

60.

Harrison RF, Davies MH, Neuberger JM, Hubscher SG. Fibrous and obliterative cholangitis in liver allografts: evidence of recurrent primary sclerosing cholangitis? Hepatology. 1994;20(2):356–61.CrossRefPubMed

61.

Vera A, Moledina S, Gunson B, Hubscher S, Mirza D, Olliff S, et al. Risk factors for recurrence of primary sclerosing cholangitis of liver allograft. Lancet. 2002;360(9349):1943–4.CrossRefPubMed

62.

Cholongitas E, Shusang V, Papatheodoridis GV, Marelli L, Manousou P, Rolando N, et al. Risk factors for recurrence of primary sclerosing cholangitis after liver transplantation. Liver Transpl. 2008;14(2):138–43.CrossRefPubMed

63.

Jeyarajah DR, Netto GJ, Lee SP, Testa G, Abbasoglu O, Husberg BS, et al. Recurrent primary sclerosing cholangitis after orthotopic liver transplantation: is chronic rejection part of the disease process? Transplantation. 1998;66(10):1300–6.CrossRefPubMed

64.

Kugelmas M, Spiegelman P, Osgood MJ, Young DA, Trotter JF, Steinberg T, et al. Different immunosuppressive regimens and recurrence of primary sclerosing cholangitis after liver transplantation. Liver Transpl. 2003;9(7):727–32.CrossRefPubMed

65.

• Steenstraten IC, Sebib Korkmaz K, Trivedi PJ, Inderson A, van Hoek B, Rodriguez Girondo MDM, et al. Systematic review with meta-analysis: risk factors for recurrent primary sclerosing cholangitis after liver transplantation. Aliment Pharmacol Ther. 2019;49(6):636–43 This recent meta-analysis, covering a large number of patients, confirms a number of risk factors for recurrent primary sclerosing cholangitis after liver transplantation. CrossRefPubMedPubMedCentral

66.

Egawa H, Ueda Y, Ichida T, Teramukai S, Nakanuma Y, Onishi S, et al. Risk factors for recurrence of primary sclerosing cholangitis after living donor liver transplantation in Japanese registry. Am J Transplant. 2011;11(3):518–27.CrossRefPubMed

67.

Gordon FD, Goldberg DS, Goodrich NP, Lok AS, Verna EC, Selzner N, et al. Recurrent primary sclerosing cholangitis in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study: comparison of risk factors between living and deceased donor recipients. Liver Transpl. 2016;22(9):1214–22.CrossRefPubMedPubMedCentral

68.

• Lindström L, Jørgensen KK, Boberg KM, Castedal M, Rasmussen A, Rostved AA, et al. Risk factors and prognosis for recurrent primary sclerosing cholangitis after liver transplantation: a Nordic multicentre study. Scand J Gastroenterol. 2018;53(3):297–304 This recent multi-center retrospective study reports an association between tacrolimus use and recurrent PSC which has not been described before in previous studies.CrossRefPubMed

69.

Ravikumar R, Tsochatzis E, Jose S, Allison M, Athale A, Creamer F, et al. Risk factors for recurrent primary sclerosing cholangitis after liver transplantation. J Hepatol. 2015;63(5):1139–46.CrossRefPubMed

70.

Alabraba E, Nightingale P, Gunson B, Hubscher S, Olliff S, Mirza D, et al. A re-evaluation of the risk factors for the recurrence of primary sclerosing cholangitis in liver allografts. Liver Transpl. 2009;15(3):330–40.CrossRefPubMed

71.

Joshi D, Bjarnason I, Belgaumkar A, O'Grady J, Suddle A, Heneghan MA, et al. The impact of inflammatory bowel disease post-liver transplantation for primary sclerosing cholangitis. Liver Int. 2013;33(1):53–61.CrossRefPubMed

72.

Textor HJ, Flacke S, Pauleit D, Keller E, Neubrand M, Terjung B, et al. Three-dimensional magnetic resonance cholangiopancreatography with respiratory triggering in the diagnosis of primary sclerosing cholangitis: comparison with endoscopic retrograde cholangiography. Endoscopy. 2002;34(12):984–90.CrossRefPubMed

73.

Vitellas KM, El-Dieb A, Vaswani KK, Bennett WF, Tzalonikou M, Mabee C, et al. MR cholangiopancreatography in patients with primary sclerosing cholangitis: interobserver variability and comparison with endoscopic retrograde cholangiopancreatography. AJR Am J Roentgenol. 2002;179(2):399–407.CrossRefPubMed

74.

Brandsaeter B, Schrumpf E, Bentdal O, Brabrand K, Smith HJ, Abildgaard A, et al. Recurrent primary sclerosing cholangitis after liver transplantation: a magnetic resonance cholangiography study with analyses of predictive factors. Liver Transpl. 2005;11(11):1361–9.CrossRefPubMed

75.

Heneghan MA, Tuttle-Newhall JE, Suhocki PV, Muir AJ, Morse M, Bornstein JD, et al. De-novo cholangiocarcinoma in the setting of recurrent primary sclerosing cholangitis following liver transplant. Am J Transplant. 2003;3(5):634–8.CrossRefPubMed

76.

Law R, Yerian L, Miller C, Dasarathy S. Multifocal cholangiocarcinoma in an explanted liver allograft following retransplant for recurrent primary sclerosing cholangitis. Trop Gastroenterol. 2010;31(4):317–20.PubMed

77.

Khorsandi SE, Salvans S, Zen Y, Agarwal K, Jassem W, Heaton N. Cholangiocarcinoma complicating recurrent primary sclerosing cholangitis after liver transplantation. Transpl Int. 2011;24(10):e93–6.CrossRefPubMed

78.

Lindor KD, Kowdley KV, Luketic VA, Harrison ME, McCashland T, Befeler AS, et al. High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis. Hepatology. 2009;50(3):808–14.CrossRefPubMed

79.

Rowe IA, Webb K, Gunson BK, Mehta N, Haque S, Neuberger J. The impact of disease recurrence on graft survival following liver transplantation: a single centre experience. Transpl Int. 2008;21(5):459–65.CrossRefPubMed

80.

Henson JB, Patel YA, King LY, Zheng J, Chow SC, Muir AJ. Outcomes of liver retransplantation in patients with primary sclerosing cholangitis. Liver Transpl. 2016;23(6):769–780.

81.

Crawford DH, Fletcher LM, Hubscher SG, Stuart KA, Gane E, Angus PW, et al. Patient and graft survival after liver transplantation for hereditary hemochromatosis: implications for pathogenesis. Hepatology. 2004;39(6):1655–62.CrossRefPubMed

82.

Casavilla FA, Gordon R, Wright HI, Gavaler JS, Starzl TE, Van Thiel DH. Clinical course after liver transplantation in patients with sarcoidosis. Ann Intern Med. 1993;118(11):865–6.CrossRefPubMedPubMedCentral

83.

Cengiz C, Rodriguez-Davalos M, deBoccardo G, Fiel MI, Rodriguez-Laiz G, Kovacevic M, et al. Recurrent hepatic sarcoidosis post-liver transplantation manifesting with severe hypercalcemia: a case report and review of the literature. Liver Transpl. 2005;11(12):1611–4.CrossRefPubMed

84.

Fidler HM, Hadziyannis SJ, Dhillon AP, Sherlock S, Burroughs AK. Recurrent hepatic sarcoidosis following liver transplantation. Transplant Proc. 1997;29(5):2509–10.CrossRefPubMed

85.

Casanova-González MJ, Trapero-Marugán M, Jones EA, Moreno-Otero R. Liver disease and erythropoietic protoporphyria: a concise review. World J Gastroenterol. 2010;16(36):4526–31.CrossRefPubMedPubMedCentral

86.

McGuire BM, Bonkovsky HL, Carithers RL, Chung RT, Goldstein LI, Lake JR, et al. Liver transplantation for erythropoietic protoporphyria liver disease. Liver Transpl. 2005;11(12):1590–6.CrossRefPubMed

87.

Dellon ES, Szczepiorkowski ZM, Dzik WH, Graeme-Cook F, Ades A, Bloomer JR, et al. Treatment of recurrent allograft dysfunction with intravenous hematin after liver transplantation for erythropoietic protoporphyria. Transplantation. 2002;73(6):911–5.CrossRefPubMed

88.

Seth AK, Badminton MN, Mirza D, Russell S, Elias E. Liver transplantation for porphyria: who, when, and how? Liver Transpl. 2007;13(9):1219–27.CrossRefPubMed

89.

Cholankeril G, Wong RJ, Hu M, Perumpail RB, Yoo ER, Puri P, et al. Liver transplantation for nonalcoholic steatohepatitis in the US: temporal trends and outcomes. Dig Dis Sci. 2017;62(10):2915–22.CrossRefPubMed

90.

Wong RJ, Cheung R, Ahmed A. Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the U.S. Hepatology. 2014;59(6):2188–95.CrossRefPubMed

91.

Wong RJ, Aguilar M, Cheung R, Perumpail RB, Harrison SA, Younossi ZM, et al. Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2015;148(3):547–55.CrossRefPubMed

92.

Charlton MR, Burns JM, Pedersen RA, Watt KD, Heimbach JK, Dierkhising RA. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology. 2011;141(4):1249–53.CrossRefPubMed

Titel: Recurrent Disease After Liver Transplantation
verfasst von: Nicholas Lim
John Lake
Publikationsdatum: 21.02.2020
Verlag: Springer US
Erschienen in: Current Hepatology Reports / Ausgabe 1/2020
Elektronische ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-020-00507-z

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Recurrent Disease After Liver Transplantation

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Purpose of Review

Recent Findings

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