Recurrence of Disease After Liver Transplantation

The most frequent indications for liver transplantation (LT) in the pediatric population include biliary atresia, metabolic liver diseases, autoimmune liver disease including primary sclerosing cholangitis, and acute liver failure. In contrast with LT in adult patients, the recurrence of original disease is relatively low in pediatric LT. The original liver disease does not recur in biliary atresia or in most forms of metabolic liver disease. Rather, the most important indications that can be complicated by disease recurrence after transplantation at pediatric age are as follows:• Autoimmune liver disease • Familial cholestatic syndromes, particularly bile salt export pump deficiency type 2 (also known as progressive familial intrahepatic cholestasis type 2) • (Re)appearance of cholestatic end-stage liver disease (ESLD), with its complications In this chapter, the epidemiology, diagnostic strategies, and treatment for these conditions are discussed.