Histopathological Evaluation of Recurrent Primary Biliary Cholangitis after Liver Transplantation

Abstract

The pathomorphological features of primary biliary cholangitis (PBC) is well-established. However, the distinction between PBC recurrence, and T cell-mediated rejection or chronic rejection remains as a challenge for pathologists. Due to the overlapping morphology, correct diagnosis requires a highly specific discrimination. Accurate diagnosis plays an essential role in patient management since different therapeutic strategies are used. This review focused on the role of pathologists in evaluating the allograft liver biopsy of patients with PBC as the leading cause of native liver cirrhosis. Furthermore, the clinicopathologic features of recurrent PBC, and T cell-mediated rejection or chronic rejection were discussed in detail, with emphasis in distinguishing the histopathology, morphologic variant, and diagnostic pitfalls.