In people who get liver transplants for autoimmune liver diseases like primary biliary cholangitis (PBC), a higher chance of dying seems connected more to poor kidney function and older age than to liver failure, according to a recent study published in the journal Medicina.
Autoimmune liver diseases are conditions where a person’s own immune system attacks their liver. The three main types are autoimmune hepatitis, PBC and primary sclerosing cholangitis. When these diseases become severe, patients often need a liver transplant to survive.
In the study, doctors in Turkey looked back at 94 patients who got liver transplants between 2004 and 2025. This included 26 people with autoimmune hepatitis, 28 with PBC and 40 with primary sclerosing cholangitis.
They found that a high creatinine level in the blood, which is a sign that the kidneys are not working well, raised the risk of dying. Being older at the time of surgery and being sick for a longer time also raised the risk.
Sign up here to get the latest news, perspectives, and information about PBC sent directly to your inbox. Registration is free and only takes a minute.
Interestingly, the usual scores doctors use to judge how sick a liver is (called MELD and Child-Pugh) did not predict who would die after transplant.
The researchers said their findings should be treated as early ideas that need testing in larger studies before doctors use them to guide real decisions. “The present study was not designed to develop a clinical decision tool, and these variables should not be used to modify transplant eligibility or recipient selection without confirmation in larger, prospectively characterized cohorts,” they said.
Read more about PBC prognosis
Of the 94 patients who received liver transplants, 16 died during the study. The three disease groups had similar death rates, so no single disease stood out as the most dangerous.
Half of the deaths happened within the first three months after surgery. The most common cause of death was a serious infection in the liver’s bile tubes, called cholangiosepsis.
