Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2022; 14(5): 1050-1052
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.1050
Role of biliary complications in chronic graft rejection after living donor liver transplantation
Aiman Obed, Abdalla Bashir, Anwar Jarrad, Laszlo Fuzesi
Aiman Obed, Hepatobiliary and Liver Transplant Unit, Jordan Hospital, Amman 52112, Jordan
Abdalla Bashir, Department of General Surgery, Jordan Hospital, Amman 52112, Jordan
Anwar Jarrad, Department of Hepatology, Jordan Hospital, Amman 52112, Jordan
Laszlo Fuzesi, Department of Pathology, Faculty of Medicine, University Augsburg, Augsburg 86156, Germany
Author contributions: Obed A designed the research; Obed A, Füzesi L, and Jarrad A performed research and revised the letter; Bashir A and Obed A analyzed the data; Obed A and Bashir A wrote the letter.
Conflict-of-interest statement: The authors declare no funding or conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aiman Obed, FACS, FEBS, MD, Associate Professor, Doctor, Surgeon, Surgical Oncologist, Hepatobiliary and Liver Transplant Unit, Jordan Hospital, Queen Noor Street, Amman 52112, Jordan. aimanobed@hotmail.com
Received: January 8, 2022
Peer-review started: January 8, 2022
First decision: February 8, 2022
Revised: February 14, 2022
Accepted: April 28, 2022
Article in press: April 28, 2022
Published online: May 27, 2022
Processing time: 135 Days and 14.2 Hours
Abstract

Postoperative biliary complications remain a substantial challenge after living donor liver transplantation, especially due to its heterogeneous clinical presentation.

Keywords: Chronic graft rejection; Biliary complications; Living donor liver transplantation; Graft survival; Cholangiopathy

Core Tip: In clinical practice, post-transplant cholangiopathy is a multifactorial process, including not only biliary complications like biliary leakage, biliary infection and biliary stricture, idiopathic post-transplant chronic hepatitis, fibrosing cholestatic hepatitis, and viral infections like cytomegalovirus but also chronic graft rejection. The post-transplant cholangiopathy substantially influences graft, as well as patient outcome and survival. Therefore, it is of outmost importance to distinguish the underlying etiology while simultaneously appreciating the heterogeneous nature of post-transplant cholangiopathy. A better understanding of clinical and histopathological features can result in an improved therapy strategy.