Updates in the Pathogenesis and Management of Rejection Post Liver Transplant

Chronic rejection (CR) of liver allografts is an indolent mostly progressive immune-mediated damage to intrahepatic vessels and bile ducts and may lead to graft failure, which might be irreversible, leading to graft loss necessitating re-transplantation. It is characterized primarily by fibrointimal hyperplasia of arteries, obliterative arteriopathy, ductopenia, interstitial fibrosis, and atrophy of parenchymal elements. CR is declining owing to surgical technique improvements, and the development of more potent immune-suppressive medications, yet more research is needed to fill the gap of knowledge. The vasculopathy is also noted to result from venous congestion due to inadequate venous outflow surgical reconstruction.

In this Research Topic, we aim to explore questions such as:
- How much do we know about the prevalence of post-liver transplant chronic rejection worldwide?
- How much do we know about chronic rejection etiology in different countries of the world?
- What are promising current and future treatments effective in controlling the march of chronic rejection?
- What are the most promising adjuvant therapies to prevent or delay cirrhosis?
- What are the surgical interventions to reduce chronic rejection?

We welcome all insights and types of manuscripts that address chronic rejection post-liver transplantation susceptibility, etiology, risk factors, diagnosis, management, natural history, treatment, transplantation challenges, outcome, burden, and prevention.

Keywords: chronic rejection, liver transplantation, pediatric, ductopenia, venous outflow insufficiency

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.