Late allograft failure: Liver

Dysfunction and subsequent loss of a liver allograft can have dire consequences for the recipient. Acute and chronic rejection, an ongoing risk for the lifetime of the allograft in the vast majority of liver transplant recipients, is a minor problem, except when levels of immunosuppression fall. The more common complications leading to late loss of the allograft in liver recipients are recurrence of the disease that lead to the transplant in the first place and biliary strictures related to different etiologies. This manuscript provides an overview of the scope of the problem and different management options for the transplant physician.