Primary Biliary Cirrhosis and Liver Transplantation

Primary biliary cirrhosis is a chronic liver disease of unknown cause that predominantly affects middleaged women.1 The syndrome of primary biliary cirrhosis arises as a consequence of a chronic nonsuppurative destructive cholangitis that involves the septal and larger interlobular bile ducts.2 The rate at which the bile-duct lesions evolve varies and is unpredictable. In asymptomatic patients the prognosis can be good (two decades), but once patients have symptoms attributable to the disease, its course is typically characterized by relentless destruction and loss of bile ducts, slowly progressive intrahepatic cholestasis, periportal piecemeal necrosis of hepatocytes, hepatic fibroplasia, and after a few . . .