Surg Clin North Am 2019 Apr;99(2):387-401
General Surgery, University of Alabama at Birmingham, 1808 7th Avenue South D202 Boshell Building Birmingham, Alabama 35233, USA; Division of Transplantation, University of Alabama at Birmingham, 701 19th Street South 722 Lyons Harrison Birmingham, Alabama 35233. Electronic address:
Orthotopic liver transplantation (OLT) has many roles in biliary disease. OLT provides excellent results for patients with unresectable hilar cholangiocarcinoma. OLT prolongs survival in primary biliary cirrhosis not responsive to therapy and improves quality of life. OLT remains the durable option for patients with primary sclerosing cholangitis and complications of end-stage liver disease or recurrent cholangitis secondary to biliary obstruction. Indications for OLT after bile duct injury are chronic liver disease secondary to biliary cirrhosis and acute liver failure from associated vascular injury. OLT is treatment of choice for Caroli disease and syndrome when fibrosis leads to portal hypertension and esophageal varices.