Cirrhosis can recur after liver transplant

22 Sep 2026, 21:20 · Medical Xpress

by Elana Gotkine

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Cirrhosis can recur after liver transplantation, according to a study published online Sept. 3 in Portal Hypertension & Cirrhosis.

Abhinav K. Rao, M.D., and Don C. Rockey, M.D., from the Medical University of South Carolina in Charleston, examined consecutive adult patients who underwent liver transplantation for cirrhosis and were followed between Jan. 1, 1987, and Dec. 31, 2023.

Data were included for 937 unique patients; 107 (11.4%) developed cirrhosis after transplantation, with a median of 7.8 years to cirrhosis after transplantation. The researchers found that 83.2% of patients developed the same liver disease that initially caused cirrhosis and resulted in liver transplant. After transplantation, autoimmune hepatitis and primary biliary cholangitis most commonly recurred (29.1% and 21.2%, respectively). De novo cirrhosis occurred in 1.9% of all patients (18 patients), accounting for 16.8% of patients who developed cirrhosis.

It was most often due to chronic rejection or metabolic dysfunction-associated steatohepatitis (nine and four of 18 patients, respectively). Survival at 20 years after liver transplant was significantly lower for patients with cirrhosis after transplant compared with those without cirrhosis after transplant (50.6% versus 70.7%; hazard ratio, 1.77).

"Our findings show that cirrhosis after transplantation is uncommon, but when it develops, recurrence of the original liver disease is the most frequent explanation," Rao said in a statement. "The particularly high recurrence rates observed among patients transplanted for autoimmune hepatitis and primary biliary cholangitis emphasize the need for continued surveillance of liver health after transplantation."

More information

Abhinav K. Rao et al, Recurrent and De Novo Cirrhosis After Liver Transplantation, Portal Hypertension & Cirrhosis (2026). DOI: 10.1002/poh2.70068

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