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Levy C, Sultan S. Is Ursodeoxycholic Acid Really a Posttransplant Panacea? Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2021 Jun 1; 27(6):791-793.
Recurrent primary biliary cholangitis (rPBC) occurs in up to 53% of LT recipients transplanted for PBC and negatively impacts long term graft (Hazard ratio 2.01) and patient survival (hazard ratio 1.72)(1). In multiple cohort studies, use of ursodeoxycholic acid (UDCA) post transplantation has been associated with a reduced incidence of rPBC. Biliary complications are reported in 10-35% of all liver transplant (LT) recipients and are clearly associated with increased morbidity and mortality(2). The term "biliary complications" encompasses a wide range of problems, including sludge, stones, casts, bile leaks, bilomas, anastomotic and non-anastomotic strictures and hemobilia. Conflicting data exist with respect to the benefit of UDCA post-LT to prevent biliary complications in general.