[Does the primary disease recur following liver transplantation?]

A number of underlying diseases may recur after orthotopic liver transplantation. While the recurrence of cholestatic diseases such as primary biliary cirrhosis and primary sclerosing cholangitis is still debated, and occurs, if at all, rarely and late after transplantation, the chronic viral hepatitides and the liver tumors recur frequently and in general early after grafting. Except for hepatitis B and tumor recurrence, recurrent diseases have rarely an impact on survival and/or quality of life in medium terms. The frequency of the often fatal hepatitis-B reinfection can be minimized by passive immunoprophylaxis and appropriate patient selection, that of tumor recurrence by thorough patient selection. Relapses occur only rarely after transplantation for post-alcoholic cirrhosis, provided stringent selection criteria, including a period of documented sobriety > or = 6 month prior to transplantation, are applied. Thus, except for chronic hepatitis B with ongoing viral replication and most liver cancers, the possibility of recurrent disease is not a contraindication to liver transplantation.