American Board of Internal Medicine (ABIM) Certification Practice Exam

Following liver transplantation for primary biliary cholangitis, what is the occurrence rate of disease recurrence?

1. 10%

2. 20%

3. 30%

4. 40%

The correct answer is: 20%

The occurrence rate of disease recurrence following liver transplantation for primary biliary cholangitis (PBC) is approximately 20%. This statistic is drawn from clinical observations and studies that monitor patients post-transplant for signs of recurrent disease. PBC is characterized by the autoimmune destruction of the bile ducts, leading to cholestasis and progressive liver damage. In transplant recipients, while the liver itself is replaced, the autoimmune nature of PBC means that the underlying predisposition for the disease does not disappear. This results in a noted incidence of recurrence in a subset of patients. Monitoring for this recurrence is crucial as it can impact the long-term outcomes of liver transplant patients. In contrast, the rates of recurrence that are higher, such as 30% or 40%, do not reflect the most commonly seen outcomes in the literature, where the recurrence is consistently reported around the 20% mark. Similarly, a lower rate of 10% does not adequately account for the recognized risk factors associated with the disease’s recurrence after transplantation.